2301 River Road
Suite 302
Louisville, KY 40206
(502)426-9680
888-426-9680
(502)426-8272 fax

The Physicians' Network

TPN MISSION/VISION STATEMENT
TPN HEALTH PLAN CONTRACTS
TPN SERVICE AREA

TPN FRIDAY FAX
TPN GROUP DISCOUNT AND PREFFERED VENDOR PROGRAMS
BENEFITS OF TPN MEMBERSHIP
CODING & DOCUMENTATION AUDITS
OIG COMPLIANCE PROGRAM
HIPAA IMPLEMENTATION
IMPORTANT LINKS AND PHYSICIAN PRACTICE WEBSITES

CURRENT LIST OF PARTICIPATING PHYSICIANS

Mission Statement top

In order to assure effective physician input into decisions that affect physicians, patients, and the community, The Physician's Network is formed to affect favorably the health and economic well-being of the community. We will plan for and promote the delivery of high quality, cost-effective health care with all who share this goal. Through this effort, we seek to deserve the respect of our community and provide a congenial professional atmosphere for our members.

Vision Statement

The Physicians' Network is committed to providing community benefit through the coordination of health system services in the most cost-effective manner to achieve the maximum health benefit. The organization will strive to assist its members in providing the highest quality medical services in the most economical manner. It will provide measurable value through cost and performance data and will endeavor to improve value through member education and rewarding for value. Value will be defined as the health benefit or outcome of health care as related to the cost, aiming for the maximal benefit at the least necessary cost. The physician's perspective will guide the structure and function of the organization. Quality and appropriateness analysis will be guided by the physician's professional ethic. The organization believes these goals can be achieved while preserving a favorable physician practice environment, including appropriate physician decisional authority; secure and satisfying practice conditions, and fair and equitable reimbursement.

TPN PARTICIPATING PHYSICIANS top

 

Click here for a listing of our current members.

Click here for an application.

Click here for a current access of care survey to complete.

TPN HEALTH PLAN CONTRACTS top

TPN SERVICE AREA top

TPN serves the following counties in Kentucky:

  • Anderson
  • Bourbon
  • Boyle
  • Clark
  • Clay
  • Estill
  • Fayette
  • Fleming
  • Franklin
  • Garrard
  • Grant
  • Harrison
  • Jessamine
  • Knox
  • Laurel
  • Lewis
  • Madison
  • Mason
  • Mercer
  • Montgomery
  • Nicholas
  • Perry
  • Powell
  • Pulaski
  • Rockcastle
  • Scott
  • Taylor
  • Whitley
  • Woodford

TPN FRIDAY FAX top

"Friday Fax" is the weekly communication between the physicians and TPN. It contains time-sensitive, health plan and pharmacy information, physician articles, coding tips, compliance guidelines, credentialing information and so much more. The website contains about 18 months of historic Friday Faxes for your reference.

Friday Fax Log-In

TPN GROUP DISCOUNT AND PREFERRED VENDOR PROGRAMS top

Participation in each TPN group discount program is entirely optional. While TPN believes most TPN physicians will benefit from participation in the group discount programs and hopes each physician will give the programs a try, participation is not required. Many of the group discount programs are 'volume driven,' meaning the more physicians who participate (or the more products and services which are purchased), the higher the discounts offered by the various vendors. Group purchasing discounts are subject to vendor requirements.

Group Purchasing and Preferred Vendor Programs

Group Purchasing is a new program that PHD has developed to assist practices with stable, low cost on commonly ordered supplies and services. We are currently working with 5 companies.

Childrens' Practicing Pediatricians (CPP) was formed in 1985 by the pediatricians on the medical staff of Columbus Children's Hospital. The organization has an all physician board of directors that guides its purpose. True to its roots, CPP continues to advocate for physician members through coding initiatives, interfacing with the AAP, and pursuing legislative relief from managed care inequities. Aventis Pasteur and Merck Vaccines are available through this program.

Mackey Printing Services offers cost savings on all of your printing needs:Appointment/business cards, Brochures, Folders, Forms, (carbonless sets, laser, 1-part), Labels, Letterhead/Envelopes. Contact us for promotional product ideas - thousands of items ranging from apparel to calendars to pens, etc. We offer design and direct mail for brochures and postcards. Let Mackey Printing help you with your marketing.

Misys - Practice Management and Electronic Medical Record solution

Prime Office Products has been in the office products business for over 20 years, taking care of customers at the highest level of service available anywhere. The contract offers huge discounts on everyday office supplies and currently has over 25,000 products available through the catalog.

Quest Diagnostics has negotiated an agreement with PHD to offer offices laboratory services at a reduced rate. This pricing is good for any laboratory services that you draw blood for in the office and for any health plan that will allow you to complete 'pass-through billing'. PHD can assist the practices in possibly increasing income with this new program. We can complete an on-site analysis of the existing laboratory usage to see if it would benefit the practice financially to offer additional laboratory services in house, or to complete pass-through billing.

Sterling Medical Consultants (SMC) is a Preferred Vendor. SMC strives to provide superior physician practice management services, tailored to the physician's needs. They offer an extensive list of services that can be customized to any size practice. SMC has personnel experienced in providing physician practices with claims filing, financial management, operational management, information systems management, and human resources management. Within each area of expertise they provide an appropriate level of service for any physician practice, from consulting and supervising projects to day-to-day operational functions.

Physician Practice Employee Health Insurance*
Medical Malpractice Insurance*
*still investigating - continue to check back for updates

BENEFITS OF TPN MEMBERSHIP top

Advantages of being a TPN member

  • Credentialing is simplified and delegated by all 12 contracted health plans.
  • TPN provides a higher level of Provider Relations services.
  • Semi-annual blended formulary cards and pharmacy education provided by our clinical pharmacist.
  • Assistance in obtaining clinical trials for the member
  • Contracted Health Plans either pay Network Access Fees or improved reimbursement schedules for TPN members.
  • Bi-Weekly Communication (Friday Fax)
  • Monthly Medical and office supply matrix showing prices by various local vendors for finding the best buys.

CODING & DOCUMENTATION AUDITS top

  • Completed by Certified Professional Coders (CPC)
  • Can be done via Fax, Mail, or On-Sit
  • Physicians receive:
    • E & M Audit Summary with findings documented at the group and individual leve
    • Executive Summary includes "official" documentation to back finding.
    • Detail to reflect which of the documentation areas need additional monitoring (HPI, Exam, MDM)
    • Financial Analysis including lost revenue when compared to Medicare fee schedule
  • Interactive CD with Case Studies available
  • On-Site Consultation available
    • CPC rounds with Physician to determine correct coding and documentation requirements
    • Training and Q&A with physicians
    • Development of practice specific documentation checklists
  • Quick turn-around

PHD's experience shows that 85% of physicians miscode at least 20% of their office visits. Over 40% of physicians under-code more than 20% of their office visits - costing them in excess of $30,000 per year. We have a simple program that reduces under-codes and over-codes by over 50%.

OIG COMPLIANCE PROGRAM top

  • Conducted by Certified Compliance Officers (CCO)
  • Speeds and optimizes proper claims payment
  • Minimizes billing errors
  • Reduces chances that an audit will be conducted by CMS or the OIG
  • Helps to avoid conflicts with the self-referral and anti-kickback statutes
  • Eliminates potential "Whistle Blower" or Qui Tam lawsuits by sending an important message to a physician practice's employees that while the practice recognizes that mistakes will occur, employees have an affirmative, ethical duty to come forward and report erroneous or fraudulent conduct, so that it may be corrected.
  • Practices Receive:
    • Customized Compliance Program with binder
    • Baseline audit information
    • Employee Statement
    • Medicare ABN - Medicare Lab ABN
    • Commercial Insurance ABN
    • Internal Investigation Log
    • Education/Training Log

HIPAA IMPLEMENTATION top

After doing extensive market research into the HIPAA products available, PHD picked the best-of-the-best to assure the success of the practices with the implementation and staff education of the physician offices. The program has been reviewed for compliance with Indiana and Kentucky law.

Our objectives for physician practices are:

  • To achieve compliance in the shortest possible time
  • Reduce the overall cost of compliance
  • Minimize the impact of the compliance effort on day-to-day operations

Includes:

  • Detailed project plan with a prioritized step-by-step approach
  • Activity worksheets with specific instructions, prioritized step approach
  • HIPAA reference material, including Federal Regs and proposed changes
  • Document templates
  • Staff education materials
  • Binder
  • Customized forms
  • Ongoing updates

Important Links and Physician Practice Websites top

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