eNews - Spring 2018

Understand the Doctor/Patient Relationship Condition

Did you know the AAOIC policy has a requirement that insureds must perform a comprehensive examination of all patients they plan to treat; and that appropriate diagnostic records must be obtained and studied, on which any resulting diagnosis, treatment plan or treatment recommendation will be based? In addition, the patient’s progress must be regularly monitored or there must be documentation that an attempt was made to do so.

The AAOIC professional liability policy has a Doctor-Patient Relationship condition.  Please read your policy carefully and be aware of the Conditions of Coverage as well as the Policy Exclusions. These are very important things to know and may preclude coverage issues in the event of a claim. 
 

The More You Know . . .

▪ Email Addresses Are Important

When it is time to renew your AAOIC professional liability policy, we will notify you via US Mail approximately 60 days prior to the expiration date of the policy and that notice will be sent to the last address that you provided to our office.  We will continue to remind you via email approximately every 15 days until you renew your policy.

We do this not to inundate your email box but because insurance coverage is extremely important.  When your policy expires, you are not covered and you begin to self-insure in the event of a loss.  Don’t let that happen. Keep your insurance coverage current.  Remember to keep AAOIC informed of a good email address, or provide a second contact if necessary and please read those emails from us.

▪ Wow! For Two Years
Stay on top of risk issues and save 10 percent in premium for two policy years!  If you have attended an AAOIC approved risk management program in the past 12 months, you already qualify. If you returned your attendance certificate following a program or the exam following the completion of the DVD, the premium credit will be reflected on your upcoming policy renewal. 

We hope that you had the opportunity to attend an AAOIC risk management program at the 2018 Annual Session in Washington, D.C.  If so, if you returned your attendance certificate to Patricia Akram the same day, the 10 percent discount will appear as a premium credit at the time of your next policy renewal and the year thereafter.  If you did not attend an Annual Session presentation, note that by September the 2018 Risk Management DVD or flash drive will be available. By purchasing the DVD or flash drive and following the instructions after viewing the program, you also become eligible for the 10 percent premium savings.  Credit for two policy years!

An Employment Practices Liability (EPL) Plan for Your Practice

According to the U.S. Equal Employment Opportunity Commission (EEOC), discrimination claims resulted in a combined $398 million in resolution and litigation payouts in 2017.¹

Do you know how to prevent employee-filed lawsuits from damaging your practice's bottom line and reputation?  Just how seriously should you take the dangers of EPL claims?

Look at these findings from the 2017 EEOC Charge Statistics Report:²

• The government resolved 99,109 discrimination cases in 2017
• Allegations of retaliation comprised 48.8 percent of charges
• Over 28,000 accusations of racial discrimination were leveled
• Nearly 1/3 of the claims were related to disability
• The EEOC processed 540,000 calls and 155,000 inquiries

EPL claims usually require serious time and funds, because:³

• The average duration of an EPL case is 318 days
• $160,000 is the average cost of claims resulting in a defense and settlement payment

As employees stand up for their rights in record numbers, businesses need to be uncompromising with compliance to avoid litigation.

Here's something else to consider: Many orthodontists treat their staff like family. Family members often take their issues to court when they quarrel. Likewise, a once-happy employee can turn to litigation when they're dissatisfied. 

Prevention is Protection:  Employee disputes occur hundreds of times each week throughout America. Protect yourself by taking precautions to prevent claims from being leveled.

Here are some practical tips for getting started:

- Stay Educated on the Law: Build your risk defense strategy by knowing and following current anti-discrimination laws, which vary by state. If your practice complies with all legal requirements, you reduce the threat of litigation.

Place special emphasis on unbiased hiring procedures, comprehensive equality training for employees, and appropriate disciplinary action for staff members who engage in discriminatory comments or actions.

For a full list of mandatory employer equality laws and regulations, visit www1.eeoc.gov/laws.

- Maintain Comprehensive Records: If you face a false allegation in court, thorough documentation will be your strongest ally. Every reported or observed instance of discrimination, and the subsequent disciplinary action taken, should be quickly and accurately recorded to ensure the evidence is on your side.

- Don't Fight Alone: Even if nobody in your practice engages in wrongful discrimination, a single claim from an employee can trigger a wave of legal fees. If you're cleared of improper conduct, legal battles can still cost you time and money. That's why it's critical to safeguard your assets with employment practices liability insurance (EPLI).

EPLI covers companies for damage and defense costs arising from a wide range of allegations, including:

• Discrimination based on gender, race, national origin, religion, disability, and sexual orientation 
• Wrongful termination or retaliation
• Sexual harassment
• Negligent evaluation or mishandled employee discipline

By implementing these measures, you can mitigate the risk of employment practice liability and invest your company finances toward improving your practice instead of salvaging it.

AAO offers EPLI coverage that's designed to protect your practice from the financial fallout of employee claims. This coverage is not included with most malpractice policies.

To learn more about the benefits of AAO-Endorsed EPLI, visit aao-insurance.com or call 800.622.0344.  Coverage may vary or may not be available in all states.

¹"EEOC Releases Fiscal Year 2017 Enforcement and Litigation Data." U.S. Equal Employment Opportunity Commission. United States Government. Web. 25 January 2018.

²"Charge Statistics (Charges filed with EEOC)." U.S. Equal Employment Opportunity Commission. United States Government. Web. 5 April 2018.

³"The 2017 Hiscox Guide to Employee Lawsuits." Hiscox. Web. 5 April 2018.

Terminating Treatment for Non-Payment of Fees

Do you have a patient or a family with unpaid fees?  How do you handle that? Has  your office asked that the account be brought current—with no response in months?  We all need money to live; if patients are not paying, should you provide the work?  Are you contemplating terminating treatment?  If so, there are some issues to consider.

Terminating treatment for non-payment can be “tricky.” The patient is likely to portray the orthodontist as being more interested in economic gain than in her/his patient.  This is especially true if the patient is a child. Additionally, the law will not hold the negligence of the parent (non-payment) against the child. Any litigation, therefore, will have a significant chance of resulting in negative consequences for the orthodontist.

If your patient is an adult, before you terminate, determine if the treatment is at a place that will pose no dental/medical risk to the patient. Advise that the treatment will end, and you will provide a retainer to preserve the progress to date. If the patient is a child, and is cooperating with treatment directives, it is safest to complete the treatment without payment.
 

It is not advisable to file a collection action against a patient or family while treatment is ongoing. That will create an adverse relationship between the parties, and likely result in either dental board complaints or malpractice claims. 
 

Steps to Follow in the Event of a Patient Complaint or Claim

If you receive a patient complaint or claim, consider the following recommendations.

1.       Call your insurance representative. If you have a conversation with a patient or a family member who has expressed dissatisfaction with the treatment, give your insurance representative a call to discuss what happened and what to do.

2.       Have your information on hand. You will need to provide key information from the patient's record. Access to the file or computer record during the telephone call will save time.

3.       Anticipate a return call. Make sure you leave telephone and fax numbers so that your insurance representative can contact you. If you are insured with the AAO Insurance Company (a Risk Retention Group) (AAOIC) and have encountered an incident or claim, contact AAOIC Claims Representative Jessica Kaesberg, or AAOIC Claims Manager Elizabeth Franklin at 401 N. Lindbergh Blvd., St. Louis, MO 63141-7816. The AAOIC hot-line number is 800-240-2650. You can also report an incident or claim through the AAOIC website (aaoic.com). The AAOIC welcomes the opportunity to work with you.