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Dr. Mulligan is both a practicing dentist and attorney in Pennsylvania. He graduated from the University of Pennsylvania in 1988 and returned to the Philadelphia area after completing his law degree in New York. Since that time, he has maintained a private practice in general dentistry in Kennett Square, Pennsylvania. His law offices are located in Philadelphia and the surrounding suburbs. His practice of law is devoted to all areas of personal injury. He has authored and published numerous articles in the field of dentistry as it relates to law. He devotes his time equally among the professions. Dr. Mulligan has been a featured lecturer at continuing education seminars involving dentistry and law. His dental lectures involve all areas of the law and the impact they have on a practice. Being actively involved in both professions, Dr. Mulligan will address topics and issues that practitioners will be confronted with at some time in their practice including but not limited to: practice management and structure (i.e. corporate entities, operating and partnerships agreements); real estate issues; tax issues; state board, insurance and government inquiries; insurance coverage issues; handling patient complaints and disputes; billing; ADA codes; HIPPA regulations; OSHA requirements; patient records; and malpractice. Dr. Mulligan encourages an interactive seminar with active audience participation. Seminar attendees may also e-mail Dr. Mulligan at [email protected] prior to the seminar with any questions or issues they have (any and all inquiries will be held in the strictest confidence).
There are many benefits of being a member of organized dentistry. I feel that one of my obligations as an officer is to keep our members informed of these benefits and encourage them to take advantage of the great services provided. Unfortunately there are a number of benefits that exist that are not fully understood or utilized to their potential. One such benefit is Peer Review. Therefore I would like to spend a few moments and a little ink this month to describe the peer review process and encourage you to utilize it should the need arise.
The intent of dentistry’s peer review system is to resolve problems between the dentist and patient or third party payer expeditiously, fairly and in a confidential manner. The kinds of disputes that may be resolved through peer review are complaints about the quality of care, and the appropriateness of care. Participation in peer review is voluntary. Each party must sign a consent indicating their willingness to cooperate with the peer review committee, which consists of volunteer dentists from the component society. By signing the consent each individual agrees to accept the committee’s decision as binding and enforceable under New Jersey law and waives their rights to have the dispute settled in a court of law. Peer review will not accept cases if legal action is in process or if a complaint has already been submitted to the State Board of Dentistry. Attorneys may not represent either party in the peer review process.
While the actual process is conducted through the component peer review committees; Middlesex Peer Review being chaired by Dr. Sandy Goldstein; NJDA’s Council on Peer Review, chaired by Dr. John Fahsbender, is responsible for the oversight and administration. The Peer Review volunteer dentists are required to undergo training at an ADA/NJDA sponsored workshop and must renew their training every three years.
A request for Peer Review is made through the Council staff at NJDA who assigns a case number, obtains consents and then forwards the case to the component chair who decides if mediation is appropriate. If this is the case, the appointed mediator from the component contacts all parties and attempts to reconcile their differences. In mediation the patient is not examined nor is any conclusion reached as to the validity of the complaint. In my six years of experience as a mediator, the vast majority cases are resolved through mediation, thus avoiding lawyers, courts, and the State Board. It should be noted that the component peer review committee will review cases involving general dentistry, while disputes concerning specialists are referred to the appropriate specialty committee.
If mediation is not successful the entire component committee will conduct a summary or plenary hearing. In a summary hearing the committee considers the records and other written information. In a plenary hearing both parties are invited to attend and give testimony, and the patient may be examined. The committee then meets to discuss the findings and submits a report to the council staff at NJDA who in turn forwards the committees findings to each party. When the committee finds in favor of the dentist, the patient or third party carrier will be directed to pay the outstanding balance owed. When the committee finds in favor of the patient or insurance carrier, the dentists may be directed to adjust or redo the treatment if the patient is willing. If not, the committee may direct the dentist to return all or a portion of the fees paid for the treatment in question. Under no circumstances will the amount of the refund exceed the amount paid for the treatment in question. Any refund is handled through the NJDA Peer Review Escrow Account, and the patient must sign a release. By following this procedure nothing is reportable to the National Data Bank.
Either party may file an appeal within 30 days. This appeal must be based on: proper procedure not followed; new information is available; the decision runs counter to the evidence or testimony presented. Appeals are referred to a subcommittee of the NJDA Council on Peer Review, who if an appeal is warranted will remand the case back to the original component committee, appoint a new committee, or refer the case to the NJDA Council on Peer Review.
I would like to point out a few important items. If a patient submits the dispute the process is open to all NJ dentists whether they are members or not, but only a member dentist may initiate a dispute. The committee will not get involved in fee disputes. There is no cost to either party. The committee members are very fair and completely unbiased. Everything is confidential. The earlier you or a patient requests mediation, the easier it is to resolve the issue at hand. This is a great mechanism to use in avoiding ugly and prolonged disputes. The better your record keeping is, the easier it is to resolve a dispute. The better you communicate with your patients, the fewer disputes you will have.
Peer review offers recourse for the patient and dentist in disputes that would not constitute a legal case, because of either the nature of the complaint or the small amount of money in dispute. It also avoids the high cost of litigation for both the dentist and patient. Using peer review, the dentist may preserve his or her good reputation and integrity in the community.
Peer review is also a very credible system in that the parties in the dispute have an opportunity to speak for themselves directly and so gain satisfaction that his or her side of the story has been accurately presented. Also, with the mediator and peer review committee being dentists, the parties in the dispute can be confidant that the oral health issue at hand is well understood by the mediator and committee.
In addition to its practical value, peer review is another route by which the dental profession demonstrates its accountability to the public and fulfills its responsibility, as a profession, to regulate itself. Through peer review the profession demonstrates that it gives its valuable time, free of charge, to resolve complaints about oral health care.
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-01/13/09
Attendance: Ashmen, Bernstein, Brunsden, Chustkie, Fertig, Galkin, Glickman, Goldstein , Kahn, Leizer, Mir Madjellsi, Modi, Nandra, Rizzi, Savage, Schambra, Simos, Stein, Villa, Vitale, Vora, Weiner
Acceptance of Minutes-vote unanimous.
President’s Report-Mark Vitale
MCDS was awarded the ADA Golden Apple Award at the November NJDA House of Delegates meeting. The award was presented by ADA 4th District Trustee Dr. Murray Sykes.
At this month’s meeting we will be honoring three MCDS life members; Joel Leizer, William Fromkin and Martin Halofsky.
I nominated Dr. Ethan Glickman for next year’s Golden Apple Award for individual achievement in mentoring.
I also nominated Dr. Richard Kahn for NJDA President-Elect 2009-2010
Treasurer’s Report-Robert Ashmen
See full report on page 3.
Educational Coordinator- David Stein
The educational committee met in December 2008. The intent of the meeting was to start planning the continuing education courses for the 2009-2010 year. The decision was made to do this as a “group effort,” as we are still transitioning to our new format of having an educational committee. Dr. Nainesh Desai was introduced as our new educational coordinator for 2009-2010. Also at this meeting a timetable was set for having the attendees contact prospective speakers, with the goal of having the schedule set by spring of 2009.
We had a wonderful educational committee meeting December 9th. We are in the process of putting together the program for 2009 and 2010. I was contacted by the NY-NJ AIDS Education and Training Center. They would like us to fill out a survey and consider organizing a presentation to educate and raise awareness on this particular area of interest.
Give Kids a Smile-Cavan Brunsden
GIVE KIDS A SMILE...GOOD NEWS IN BAD TIMES...FRIDAY, FEBRUARY 6, 2009... Over 3,000 children will receive free dental examinations, cleanings and fluoride treatments, as well as sealants and emergency care where indicated. Over seventy dental health sites throughout the state are available to provide access to care for those in need. Volunteer dentists, assistants, hygienists, and staff have given of themselves to others on behalf of the profession of dentistry. Take time and visit a site near you so that you can experience the true spirit of professionalism and the joy of giving. Helping children smile, one smile at a time...The New Jersey Dental Association.
NJDA Council Reports:
Dental Benefits-Mark Vitale
See full report on page 7.
Public and Governmental Affairs-Mitch Weiner
See full report on page 7.
Membership-Tara Savage/Devang Modi
The next Membership Council meeting will be held on January 15, 2009. We will be reviewing the current protocol for granting dues waivers and discussing some of the recommended policy changes that were requested by the Monmouth/Ocean County Dental Society trustees. Below is a summary of their requested changes and Patricia DeCotiis’s responses to the changes.
1. The current protocol states that “...a member may receive up to three consecutive financial dues waivers based on the same statement of financial need.”
MOCDS felt that a member should submit a request each year they request a waiver and have the same protocol applied each time. Ms. DeCotiis clarified that it is current protocol for a member to submit an application for dues waiver each year and that each waiver is granted for one year only unless it is based on permanent disability.
2. The current protocol states that “...a final decision on the waiver application will be made jointly by the NJDA President, President-elect and Executive Director.”
MOCDS felt that the components should have the autonomy to investigate independently and request additional information including financials and the waivers be granted with consideration to the component’s recommendations. Ms. DeCotiis noted that the current policy states, “absent compelling information to the contrary, an applicant’s statement, at the level requested, if reasonable on its face, will be accepted as true without the need for independent support or verification.” Regarding MOCDS’s request that the component have representation on the committee of individuals who review dues waiver applications, Ms. DeCotiis did not think this would present any administrative concerns and the Council would review this recommended policy change.
3. MOCDS requested that the component be allowed a minimum of thirty days to investigate the dues waiver request. Ms. DeCotiis was concerned that this would slow the waiver process and felt that members appreciate the efficiency with the current process and that it reinforces that their Association is being responsive to their needs.
New Dentists-Arpan Nandra
No meetings have been scheduled. I have contacted NJDA to follow up.
Peer Review-Sandy Goldstein
There were no new peer review cases mediated during the month of December 2008.
Committee Reports:
Corporate Sponsorship-David Stein
American Express will be coming to the January, February and March Dinner Meetings, Care Credit will be joining us for The January Meeting and The March Meeting. We will continue to try to have as many sponsors as we can.
Mentor-Co-Chairmen: Dr Amit Vora, Dr. Nima Mir Madjlessi & Dr. Ethan Glickman
Fotinos Panagakos, DMD, PhD, Director of Professional Relations-Colgate Oral Pharmaceuticals, Inc. spoke about: Diabetes: “The Two Way Street We All Travel On”. He presented this Mentor program On November 17, 2008 at St. Peter’s Medical Center, New Brunswick. 21 MCDS, 1 NJDA & 1 Non-member Dentists & 12 staff members attended the Dr. Panagakos seminar.
Dr. Marty Jablow presented a Mentor program on December 11, 2008. His seminar entitled:” Rewiring the Dental World- From G.V. Black to Google” was held at the NJDA Building. 13 MCDS, 1 NJDA & 1 Non-member Dentists & 3 staff members attended the Dr. Jablow seminar.
Kim Iannotte from the Aftco Company will present the next Mentor program on April 30, 2009. She will speak about: “Analyzing Practice Numbers, Adding an Associate, Practice Mergers & Practice Transition Options at St. Peter’s Medical Center, New Brunswick.
Our bi-annual OSHA program that satisfies the OSHA standard on Occupational Exposure to Blood Borne Pathogens, which is required annually for dentists and staff, will be given on June 11, 2009 at St. Peter’s Medical Center, New Brunswick. Two CEU credits are awarded to the Dentists & staff members attending these 2-hour seminars. These seminars are available to our members & staff for $20/pp as a member benefit of MCDS.
A very big “Thank You” to Dr. Joe Fertig, Director of Dental Services - St. Peter’s Medical Center, for arranging all our room accommodations for the MCDS-OSHA-Mentor programs at St. Peter’s Medical Center in New Brunswick.
Please see the inserts in this newsletter for additional information and registration for the OSHA & Mentor programs.
Please contact Marlene Glickman, our Exec.Sect’y for MCDS, at # 732-238-1255 for additional information and registration in advance for the programs. Thank you...
Oral Cancer Screening-Constantine Simos (Middlesex County liaison to the Oral Cancer Workgroup )
There were no meetings scheduled in December. I have been speaking to Bob Schermer (who is part of the Morris County Cancer Coalition), he is trying to plan a meeting with the Middlesex Cancer Coalition to discuss the screening program. On the agenda will be issues addressing fund-raising, participants, and resources available.
Bob is having a meeting this week in Passaic County concerning the walk-a-thon. He will follow-up after the meeting.
Dental Hygiene Study Club- Alyssa Bernstein
The Central New Jersey Dental Hygiene [CNJDH] Study Club will meet on Wednesday January 14, 2009 at the Crown Plaza Hotel, Rte 27 South, Edison NJ. The study club is being sponsored by MCDS. The speaker is Judith Heath Diem, she is speaking on Orofacial Myofunctional Therapy Series Part II.
Two CEU credits will be awarded to the Hygienists that attend this meeting. The next CNJDH meeting will be March 4 and the speaker will be Dr. James Albani and he will be speaking about Periodontics from the Hygienists Perspective. Two CEU credits will be awarded for this seminar.
This CNJDH study club is available to our hygienists as a Dentist-member benefit of MCDS.
Please contact Marlene Glickman, our Exec.Sect’y for MCDS, at # 732-238-1255 for additional information and registration in advance for the program. Thank you.
New Business
The Board voted to recommend the following slate for 2009-2010:
Board Of Trustees
President Elect - Maya Prabhu
Vice President - Robert Ashmen
Secretary - Constantine Simos
Treasurer - David Stein
ADA Delegate - Daniel Krantz
ADA Alternate Delegate - Richard Kahn
NJDA Trustee - Nancy Villa
NJDA Alt Trustee - Mitchell Weiner
NJDA Delegates
Robert Ashmen, Cavan Brunsden, Scott Galkin (chair), Richard Kahn, Daniel Krantz, George McLaughlin, Maya Prabhu, Arnold Rosenheck, Robert Silverstein, David Stein, Constantine Simos, Nancy Villa, Mark Vitale, Mitchell Weiner
NJDA Alternate Delegates
James Courey, Nainesh Desai, Peter DeSciscio, Joseph Fertig, Sandy Goldstein, Joel Leizer, Nima Mir Madjlessi, Arpan Nandra, Ira Rosen, Tara Savage, Mark Schambra, Amit Vora, Araceli Ziemba
Respectfully Submitted, Constantine Simos
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12/31/07 10/31/08 12/31/08
Checking $3,888.37 $12,016.96 $925.32
Savings $9,298.42 $17,751.19 $13,283.79
CD (3.46% matures 12/28/08)
$25,979.64 $25,000.00 $25,000.00
PayPal $4,162.26 $1,828.91 $1,229.77
TOTAL: $43,328.69 $56,597.06 $40,438.88
P&L STATEMENT CHECKING ACCOUNT
(10/31/08-12/31/08)
INCOME
CONT. EDUC.-INC 4,090.00
CORP SPON-meetings 3,000.00
DUES 800.00
HYG study club 200.00
INTEREST 7.23
MENTOR COMM-INC 1,900.00
TOTAL INCOME 9,997.23
EXPENSES
CONT. EDUC.-EXP 10,449.97
DINNER DANCE 247.00
DINNER MEETINGS 11,630.30
EXEC.COMM.DINNER 470.61
EXECUTIVE SECRETARY 1,260.00
INSURANCE 382.20
NAME BADGES 74.69
OFFICE SUPPLIES 71.00
POSTAGE 22.68
STAFF NIGHT 650.00
TELEPHONE 87.87
TOTAL EXPENSES 25,346.32
TRANSFERS
FROM PAYPAL 1,000.00
FROM SAVINGS 4,500.00
TOTAL TRANSFERS 5,500.00
OVERALL TOTAL -9,849.09
P&L SAVINGS ACCOUNT
(10/31/08-12/31/08)
INTEREST INCOME 32.60
TRANSFER TO CHECKING -4,500.00
OVERALL TOTAL -4,467.40
P&L PAYPAL MONEY MARKET
(10/31/08-12/31/08)
CONT ED INC 266.12
MENTOR COMM INC 134.74
TRANSFER TO CHECKING -1,000.00
OVERALL TOTAL -599.14
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Council on Dental Benefits
The council met on January 7, 2009 and the following items were discussed:
Dental Benefits Course: The Council on Dental Benefits will present a course on dental benefits management on Wednesday, June 3, 2009, in Atlantic City at the Annual Convention. The course, moderated by Dr. Arthur Bilenker, Vice Chair of the council, will include a panel discussion of council members, coding and claims submission tips and a discussion of contract dental arrangements. Don’t miss out – make plans now to attend.
Delta Publishes New Handbook: If you participate with Delta Dental Plan, you should have received a 2009 Delta Dental Participating Dentist Handbook; if not, it is advisable to request one and review it carefully. In addition to Delta’s claims submission documentation requirements and updated Participating Dentist Rules, Chapter 9 of the handbook contains processing policies that may impact payment for various procedures. Pay special attention to “disallowed” procedures, which may not be billed to the patient.
Check Plan Radiograph Return Policy: Members are reminded that many dental plans no longer return x-rays unless a specific request is made that they do so. Obviously, dentists should never send original x-rays with claims, but some offices would like the duplicates returned to them if needed in the future. Submitted x-rays should be appropriately mounted and labeled.
Claims Resolution Program (CRP) Continues to Assist Members: As you all should be aware, NJDA offers a Claim Resolution Program to assist members in resolving claim payment problems after all available appeals have been exhausted. In the last few years, the most common problem has been dental plans requesting refunds of “overpayments” from non-participating dentists who accepted payment for their services in good faith without knowing a mistake had been made. In those situations, case law holds that the dentist is an innocent third party creditor and NJDA writes a letter to that effect. The plan must then look to the subscriber who was the party “unjustly enriched” by the mistake. Members can download the CRP form from the Dental Benefits Center on www.njda.org. Other helpful dental plan information also can be found on that site. Of course, Dental Benefits staff at NJDA is just a phone call away to provide advice or answer questions.
Personal Injury Protection (PIP) Fee Schedule Still Pending: At the prodding of NJDA, the New Jersey Department of Banking and Insurance on June 1, 2008 finally proposed an updated PIP fee schedule to replace the current one that took effect on December 20, 2004. The proposed schedule will adjust fees for inflation by 11.3 percent in Region 1, and 11.9 percent in Regions 2 and 3. The proposed new fees, however, will not take effect until they are formally adopted and published in the NJ Register with responses to submitted comments; that process is not yet complete. The statute underlying the fee schedule rule requires them to be updated every two years. NJDA continues to pursue the prompt adoption of the new fees and will notify members as soon as they have been adopted.
Council on Public and Governmental Affairs
Lead Crowns Legislation- NJDA met with representatives from the lab community and legislators to discussed final draft amendments of this legislation.
CE Credit Waiver Legislation- Feedback from the State Board of Dentistry led to an amendment of this legislation that would now provide ½ hour of CE credit for each hour of free dental care delivered to a broader definition of underserved patients than the original draft.
Dental Amalgam Study Legislation- The climate is ripe for anti-amalgam bills and NJDA is referring legislators to various government web sites and encouraging legislators to talk to their own dentists in order to get a balanced take on this controversial matter.
NJ Paid Family Leave Act- The Act is now in effect and payroll deductions (from employee, NOT employer payroll taxes) must now be made. Informational posters concerning this Act must be displayed in offices.
PIP Fee Schedule- NJDA was told that the overdue update of PIP fees would be in the January publication. It is clear that they were not adopted yet. These fees were to be amended biennially due to legislation passed in 1996-7. In the past 13 years, the fees were updated 3 or 4 times. We eagerly anticipate the PIP fee schedule update very soon.
Communications Report- Give Kids a Smile will be on Friday, February 6th. NJDA has proposed a resolution declaring April 2009 as Oral Cancer Awareness Month in New Jersey. NJDA is working on strengthening our relationship with the NJ Office of Minority and Multi-Cultural Health.
Mandatory Children’s Dental Examination Legislative Proposal- While NJDA’s intentions are benign in wanting to mandate oral examinations for students entering Kindergarten, 3rd and 6th grades statewide, the economic climate has led legislators to shun any new piece of legislation that would lead to the lay public being forced to spend money. It is unlikely that this proposed legislation will go anywhere as a result.
MCDS Newsletter Online
If you would like to receive the newsletter electronically in lieu of receiving a printed copy, please visit our web site. Click on the “Member” link, then the “Of Current Interest” Link. By registering, you will be able to view the newsletter about a week before it would get to you in the mail, and this will also be saving us money.
Provide NJDA with your email address!
By having your email address, NJDA can get vital and timely information to you. Register at www.NJDA.org.
Give Kids A Smile! Set for 2009, Information Session Scheduled for October
Friday, February 6, 2009, will mark the 7th year of the American Dental Association’s Give Kids A Smile! (GKAS) National Dental Access Day. The program’s mission is to deliver free dental care to as many children in need as possible on this day (ages 12 and under). It’s your chance to serve as a good will ambassador for dentistry while introducing the world of good oral health to children from every corner of the Garden State.
New Jersey has participated each year with more than 1,000 volunteers and has one of the most organized and successful programs in the country. More than 13,000 children have come through our program since 2003, and we have delivered nearly $2.4 million dollars in dental care. But, in order to grow our program and reach as many children in need as possible, we need more volunteers. This is where you can help.
On Wednesday, October 29, 2008 at 4pm, at the New Jersey Dental Association headquarters in North Brunswick, Dr. Cavan Brunsden, pediatric dentist and statewide chairman of GKAS, will hold a two-hour open house information session on the program. It is designed for dental professionals and clinic management who have never participated in the event, but would like to learn all about it and what it entails. We are particularly in need of dentists and clinics in Cape May, Hunterdon, Mercer and Warren Counties. Dinner will be provided.
Some of the program’s veteran volunteers will discuss tips and techniques to make your GKAS program a success, and NJDA staff will teach you how to maximize your exposure to local area schools, businesses, houses of worship and the media. You do not have to own a practice to volunteer. Many large clinic-based sites need dentists and you can volunteer at a site in your area on February 6.
If you would like to attend the GKAS open house information session, please RSVP right away, as space is limited. You can RSVP with your name, the town and county in which you practice and the number of people you are bringing (assistants, hygienists, other office staff, etc.) to Eric Elmore at [email protected] or by calling (800) 831-NJDA and asking for Eric. We hope to see you there.