Thursday, October 8, 2015

Orange Wine On The Rise

Orange wines are dividing wine-lovers into two camps: Those who find orange wine thrilling and complex, and those who say it is the wine of trendy sommeliers and hipsters.

David Harvey of Raeburn Fine Wines coined the term ‘orange wine’ in 2004 to describe a white wine where the grapes were left in contact with their skins for days, weeks, or even months. Essentially, orange wine is white wine made as if it were a red.  However, the trend of orange wine may be new, but winemaking that produces orange wine is the oldest in the world. The wine has a unique color and is more intense on the nose and palate, and may possess significant tannins. Good orange wines balance the right amount of juiciness and acid, with hints of herbs, bruised stone fruits, or burnt orange.  Orange wines also go by the name ‘amber wines.’ Many mistakenly think the amber color signals oxidation or that the skin contact spoils the wine. The color does not come from oxidation, but rather the grapes’ skins.

Orange wines have been described as very approachable and well balanced with a fresh, fruity core. The combination of freshness with tannin makes for a versatile food wine. Levi Dalton, former sommelier at New York Italian restaurant Convivio and current writer/broadcaster explains, “Orange wines were my get-out-of-jail-free card. We had a chef who would switch from fish to meat and back again on a tasting menu and orange wines paired effortlessly with every course.”

Morgan Calcote, general manager and beverage director of the renowned restaurant FIG in Charleston, South Carolina, states, “The dining public is savvier than ever, and they are willing to make leaps of faith based on the recommendations of knowledgeable servers or sommeliers.”

Vineyards from California to Slovenia are making orange wines, and restaurants across the country are adding orange wines to their wine lists. Boutique wine shops are having difficulty keeping the wine in stock.

“There’s novelty to orange wines right now,” Calcote says. “Not quite a white, not quite a red, they occupy this ambiguous place in between. Orange wines are their own unique thing.”


Fast Company (2015).  The Rise Of Orange Wine. Retrieved September 24, 2015, from

Woolf, S. (2015). Orange Wines:  It’s Time To Get In Touch. Retrieved September 24, 2015, from

The Most Common Reasons For Health Insurance Claim Denials

Health insurance claim denials are on the rise, and some experts believe the Affordable Care Act (ACA) will be responsible for increasing the frequency of denied claims in the future.  Physician practices are losing a significant amount of administrative time and revenue due to denied insurance claims.  The American Medical Association (AMA) estimates that more than $43 billion could have been saved since 2010 if insurers had consistently paid claims correctly.

One way physicians can increase their income is to decrease the number of denied claims their practice generates.

Five common reasons for claim denials are:

·      ·     The claim form is missing a modifier or modifiers, or the modifier(s) are invalid for the procedure code (as in the case of bilateral codes billed on both sides).
·      Errors or typos were made while collecting information from the patient or during the data entry process for a claim. Something as minor as a missing hyphen, as in the case of a hyphenated name, is reason enough for the claim to be denied.
·      The claim is deficient in information, such as missing prior authorization or the effective period of time within which the pre-approved service must be provided for reimbursement to occur.
·      The patient isn’t eligible for services because his or her health plan has expired, and the patient hasn’t displayed proof of new insurance.
·      A particular service isn’t covered under the plan’s benefits, or there appears to be lack of medical necessity. Additionally, there could be a mismatch between the actual diagnosis and the service performed.

Physician practices can decrease claim denials by analyzing on a monthly or quarterly basis the main causes for denials per insurer and determining whether the errors were made by the physician’s staff or insurance company. Next, organize denials by payer explanation of benefit reason and remark codes; these identify the reason for the denial. Group the remark codes into workflows, such as claims data issues, patient responsibility, and claims that may require an appeal.  This process helps the practice make any appeals in a timely fashion and helps determine whether appealing or dropping the carrier is the best option.

When the patient visits the practice, the receptionist should scan the patient’s insurance card into the patient’s electronic health record (EHR) and ensure the card matches the patient and is valid on the appointment date. Practices should send insurers an electronic eligibility request to determine if the patient is eligible before receiving the services. The patient should be informed of which services are covered and which services he or she is responsible for paying.

“You’re looking at five percent of claims denied every year for an average family practice, that’s about $30,000 walking out the door every year,” stated Ryann Philpot, manager of revenue cycle management at e-MDs, a certified practice management software and solutions provider in Austin, Texas.

This is a good enough reason for physicians to overhaul their claims policies and procedures.


American Medical News (2013).   Claims Analysis Shows Doctors The Way To Fight Insurer Denials. Retrieved September 24, 2015, from

Medical Economics (2015). Top 15 Challenges Facing Physicians In 2015. Retrieved September 24, 2015, from

Medical Economics (2015). Top 5 Challenges Facing Physicians In 2015.  Retrieved September 24, 2015,  from

ICD-10 Is Here!

Cockerell Dermatopathology met October 1st with a sense of calm since we were prepared for the transition from ICD-9 to ICD-10. In fact, we were ready weeks ago. Over this time period, we’ve been sending live ICD-10 codes from the lab and none of our clients or vendors have notified us of any problems.

How did we do it?

Below are a few steps we took to ensure an easy transition.

1. We reviewed all of the codes submitted to payors for the previous years and ranked them from the highest to lowest in terms of frequency used.

2. Our team utilized our billing group to help analyze the existing ICD-9 codes and how they translated to ICD-10 codes. This process was reviewed and then revised more than three times to ensure accuracy.

3. We manually entered the appropriate parent or base code into the result key portion of our LIS database. If the verbiage in the result key supported a more specific code, it was added at this level.

4. For the base codes, we linked the more specific level codes where appropriate. This, in turn, created the mechanism to arrive at the more specific code(s).

5. We created 85 specific body part types to trigger the more specific codes linked above.

6. Lastly, we tested scores of scenarios to ensure that the most specific codes were attached to the report. We ensured the visible reports in all forms and formats were functional and ready for the ICD-10 start date.

“The secret to our ICD-10 success was that we started this project several months ago, well before the October 1st start date.  We brought a small but focused team together that spent hours producing detailed work to help develop a workable solution. I am extremely proud of this team,” stated Craig Reed, the IT manager at Cockerell Dermatopathology.

Dr. Cockerell praised Mr. Reed and the other staff involved in the ICD-10 transition project by stating, “I am very proud of my staff because they were proactive from the beginning and made what could have been a very painful process a seamless transition,” stated Dr. Cockerell.

Despite the headache ICD-10 is causing many physician practices, it does offer several benefits, such as the increased ability to accommodate new technologies and procedures; the sharing of public health data; the coding of data to help enhance research; the ability to track data that helps improve performance, create efficiencies, and contain costs; and the building of a foundation in which to develop payment systems.


Bowman, S. (2008) Why ICD-10 Is Worth the Trouble. Journal of AHIMA 79(3): 24-29.

Reed, C. (2015). ICD-10 Transition. [Interview]

Dr. Cockerell To Lecture On Taoism’s Influence On Dermatology Today

Dr. Cockerell will be speaking at the Texas Dermatological Society’s 2015 Annual Fall Meeting on Saturday, October 24th in Lubbock, Texas. His presentation, “Lessons for Dermatology from the Tao Te Ching,” will apply insights from Chinese Taoism dating to the 6th century B.C. to today’s field of dermatology.

The book the Tao Te Ching is a classic manual about the art of living and is one of the wonders of the world. Balance and perspective, a serene and generous spirit, mindfulness, and the drive of man to control nature are concepts explored in the book.

“Taoism is a fascinating philosophy that is applicable to the world we live in today. In terms of medicine, physicians are burned out from so many external pressures, but we all could benefit from tools that teach us how to regain passion and focus on the needs of our patients. My presentation provides physicians with tips for living a more peaceful and fulfilled life while maintaining the skills required to be an effective physician,” states Dr. Cockerell.

The target audience for the meeting is dermatologists, dermatological surgeons, pediatric dermatologists, and residents in dermatology. Educational methods used in this session will consist of an open discussion and exploration of ideas.  The educational program is sponsored jointly by the Texas Dermatological Society and Baylor Scott & White Health System.

To preview Dr. Cockerell’s presentation, please visit To learn more about the meeting, please visit


Cockerell, C. (2015). Lessons for Dermatology from the Tao Te Ching. Retrieved September 28, 2015, from 

Texas Dermatological Society (2015). 2015 Annual Fall Meeting: Attendee Brochure. Retrieved September 28, 2015, from