How prepared are you if, despite the prophylactic precautions taken by your in-house team, taken by your outside coding and billing provider, and by your EHR vendor, your defenses are breached?
A seemingly unrelated Delaware case from the world of corporate mergers reminded me of that sorry story, one that’s played out several times for clients over the past decade, one that never ends well for Dr. Quisling.
One of my college roommates had a ’74. It was an interesting car with an interesting shape, but the build quality was crap. There were gaps where the hood would close, gaps on one side of the body and not the other, and huge gaps in the interior panels — you could practically stick your finger into the dash panel next to the radio.
That reminds me of medical group insurance policies.
Your group has entity coverage for malpractice so that you’re covered for an act that one of your members is involved in. As in Dr. X, one of your employees, is sued for malpractice and the group is named as a defendant, too.
But what if you’re sued for an event that one of your own members didn’t cause? To your dismay, you find out that you’re not covered for that.
Fortunately, at least when considering these issues in advance, there are insurance products that close up the gaps in coverage.
But that means that you have to identify those gaps: What gaps exist within your entity’s coverage? In terms of malpractice coverage, general liability coverage, cyber liability coverage, D&O coverage, and so on? The only way to find out is to conduct a very thorough evaluation of what you have in place; an evaluation of the policies themselves, not just their names or descriptions.
In many cases, gap coverage can be negotiated with carriers, and what’s obtainable, and its premium, can vary widely. But, at a minimum, arm yourself with the understanding of what you have, what you might obtain, and it’s cost.
That’s because one thing is certain: After the event occurs, you can’t insure against it, at least without committing insurance fraud.
Comment or contact me if you’d like to discuss this post.
Mark F. Weiss
You say that your medical group is insured - is it really?