Figuring out how to get reimbursed appropriately for the services you provide to patients can feel as challenging as caring for your most complex patients. The financial pressures affecting physician practices are increasing and reimbursement levels aren’t keeping up. Insurers are adding administrative hurdles like prior authorization and imposing payment policies such as automated downcoding that make it even more difficult for practices to get paid for the level of services they deliver.

The claims submission process requires physicians and their administrative team to know what specific CPT® codes to use to describe a patient encounter and how to document details of the encounter in a way that supports the type and level of services billed. Choosing the proper code and documenting the proper information can be complicated, and errors can cost your practice money as a result of insurance company denials or, conversely, missed opportunities to bill for documented services.

The Illinois State Medical Society invites you to join Ana (Trajchevska) Kostovski, CPC, CPB, CPCD, from TaskForce, an ISMS Benefit Partner, for a review of proper documentation and coding practices and a discussion of current trends in physician billing and reimbursement. Ana’s presentation will include:

• An overview of how to select and document the proper E&M code level
• A review of the AMA CPT® E&M medical decision making (MDM) guidelines and how they relate to level of service provided
• How medical record documentation informs and supports CPT® selection and claim preparation
• Common billing and documentation errors to avoid

TaskForce has been an ISMS benefit partner since 2023, and provides clients with dedicated, remote teams of professionals to improve the administrative flow of physician practices by providing services such as coding, billing, scheduling, registration and referrals. TaskForce offers customized services based on the needs of individual practices and focuses integrating its services smoothly with the on-site practice team.

Please note that CME credits will not be offered for this program.

Stigma toward patients with substance use disorders remains a major barrier to effective care across healthcare settings, including pharmacies and general medical settings. It influences clinician communication, care coordination, and how patients experience the health system. In this session, John Embers, MD, and Tyler Varisco, PhD, will explore how stigma and assumptions about substance use shape everyday clinical interactions. Participants will examine how leadership, clinical culture and communication practices contribute to these challenges, and will identify practical strategies to promote more supportive, recovery-oriented care. Through real-world examples and actionable approaches, this session will highlight ways clinicians can improve communication across care settings, strengthen relationships with community partners, and support continuity of care.

Who can attend:

Registration is limited to ISMIE and SEMPIC policyholders, ISMS members, and their employed staff.

About the Presenters:

Dr. John Embers (Weems), MD, FASAM, is a practicing internal medicine physician and addiction medicine specialist. He serves as director of substance use disorders continuum integration for Central Health, Travis County’s health district, where his work advances the mission to improve community health by caring for those who need it most.

Dr. Embers trains medical students and residents as faculty at Dell Medical School. He is a co-investigator for SHOUT Texas, a U.S. Department of Health and Human Services–funded multiyear initiative to expand access to opioid use disorder treatment in safety-net hospitals across Texas. He serves as core faculty for the statewide TxRx ECHO telementoring program and contributes as a national content expert in outpatient addiction medicine for CDC-funded work with the American Hospital Association. In 2024, he was recognized as the Travis County Medical Society Young Physician of the Year.

A graduate of Harvard Medical School, Dr. Embers completed a primary care internal medicine residency followed by an addiction medicine fellowship at Massachusetts General Hospital and Charlestown Community Health Center. He is board certified in internal medicine and addiction medicine and is a Fellow of the American Society of Addiction Medicine.

Dr. Tyler Varisco, PharmD, PhD, is an assistant professor in the Health Outcomes Division and director of the Pharmacy Addictions Research and Medicine Program at the University of Texas at Austin College of Pharmacy. A registered pharmacist and health services researcher, his work focuses on improving the quality of care for people with opioid use disorder (OUD) by addressing systemic barriers to substance-related care in pharmacy and clinical settings. Dr. Varisco led a national collaboration between the National Association of Boards of Pharmacy, the National Community Pharmacists Association, and academic partners to develop the Pharmacy Access to Resources and Medication for OUD Practice Guideline. He currently serves as a subject matter expert for SAMHSA’s revision of Treatment Improvement Protocol 63 and as principal investigator for the Texas Opioid Training Initiative, a SAMHSA and Texas Health and Human Services program to build opioid and stimulant use disorder prevention and treatment capacity in Texas.

Learning Objectives:

• Summarize how stigma and assumptions about substance use affect communication across care settings
• Identify strategies to improve care coordination for patients with substance use disorders
• Identify how leadership and clinical culture influence stigma in care delivery and identify ways to promote more supportive, recovery-oriented practices
• Describe practical ways clinicians can build relationships across care settings to support patients with substance use disorders and improve continuity of care

Accreditation: This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of the Illinois State Medical Society and ISMIE Mutual Insurance Company. The Illinois State Medical Society is accredited by the ACCME to provide continuing medical education for physicians.

Credit designation: The Illinois State Medical Society designates this live activity for a maximum of 1 AMA PRA Category 1 Credit^TM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Disclosure: The planners, faculty, and others in control of content have no relevant financial relationships with ineligible companies.