Summer 2017 Employee Edition

LMG “In the Know”

2

Welcome to the

2017 Summer Issue

of the LMG Newsletter!

Inside this issue:

Type 2 Diabetes—Knowing Your Numbers 3 LMG IT 14

Tips for Preventing Heat-Related Illness 4 EMR News Corner 15

Steps to Safe and Healthy Fruits & Vegetables 6 LMG Human Resources 16

StoneSprings Hospital Center 8 LMG Coding Update 19

LMG Family Medicine and Pediatrics Word Search 11 Town of Leesburg Flower and Garden Festival 20

From the Doctor’s Desk 12

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Hearing the diagnosis “Diabetes” can elicit many feelings

and emotions. Fear and uncertainty are, most likely, at the

top of that list. Educating yourself about your new

diagnosis is great way to assuage some of those fears.

When you have Diabetes, the glucose (sugar) levels in the

blood stream can become too high. Over time, high blood

glucose levels can cause damage to your heart, kidneys,

eyes, and feet. Controlling your blood glucose, blood

pressure and cholesterol can help to better manage your

Diabetes and reduce the risk of other complications.

Doctors are able to measure Hemoglobin A1c, which

shows average blood glucose levels over a 2-3 month

period. According to the American Diabetes Association,

target A1c levels should be less than 7%. (Check with your Diabetes care team for your specific goal.) If A1c levels are

not on target, they should be measured at a diabetes office visit every 3

months. If A1c levels are on target, they will still need to be measured at

least twice a year.

Other blood glucose goals are:

Fasting blood sugar before meals- 80-130 mg/dL

1-2 hours after meals- less than 180 mg/dL

Exercise and a lower carbohydrate diet are vital to managing these

numbers. At your next appointment, bring in a 3 day food log of

everything you eat and drink. Let your Diabetic care team look over your

food log and offer suggestions on how to improve your diet.

Knowing your numbers is an important step to managing Diabetes and

reducing the risk for complications. At your next office visit ask for your

numbers: A1c, BP and cholesterol.

Also included in your Diabetes care should be:

Yearly Eye Exam: Patients with diabetes need a yearly dilated eye exam. Be sure to ask that your results be sent to your

diabetic care team. Follow-up with your Ophthalmologist if you notice any change in your vision.

Foot Care: You should also routinely check your feet for cuts, blisters, swelling and cracked skin. Do not go barefoot

and wear shoes and socks that fit properly. Your diabetes care team should check your feet at your Diabetes follow-up

appointments.

Dental Exam: Visit the Dentist at least every 6 months.

Immunizations: Be sure to ask your doctor if and when you need shots for flu, pneumonia, and Hepatitis B.

Featuring Nicole Price, CFNP | LMG– Leesburg Sterling Family Practice

4

STAY COOL

Wear Appropriate Clothing: Choose lightweight, light-colored, loose-fitting

clothing.

Stay Cool Indoors: Stay in an air-conditioned place as much as possible. If your

home does not have air conditioning, go to the shopping mall or public library—even

a few hours spent in air conditioning can help your body stay cooler when you go

back into the heat. Call your local health department to see if there are any heat-relief

shelters in your area.

Keep in mind: Electric fans may provide comfort, but when the temperature is in

the high 90s, they will not prevent heat-related illness. Taking a cool shower or

bath or moving to an air-conditioned place is a much better way to cool off. Use your stove and oven less to maintain a

cooler temperature in your home.

Schedule Outdoor Activities Carefully: Try to limit your outdoor activity to when it’s coolest, like morning and evening

hours. Rest often in shady areas so that your body has a chance to recover.

Pace Yourself: Cut down on exercise during the heat. If you’re not accustomed to working or exercising in a hot

environment, start slowly and pick up the pace gradually. If exertion in the heat makes your heart pound and leaves you

gasping for breath, STOP all activity. Get into a cool area or into the shade, and rest, especially if you become lightheaded,

confused, weak, or faint.

Wear Sunscreen: Sunburn affects your body’s ability to cool down and can make you dehydrated. If you must go outdoors,

protect yourself from the sun by wearing a wide-brimmed hat, sunglasses, and by putting on sunscreen of SPF 15 or higher

30 minutes prior to going out. Continue to reapply it according to the package directions.

Tip: Look for sunscreens that say “broad spectrum” or “UVA/UVB protection” on their labels- these products work

best.

Do Not Leave Children in Cars: Cars can quickly heat up to dangerous temperatures, even with a window cracked open.

While anyone left in a parked car is at risk, children are especially at risk of getting a heat stroke or dying. When traveling

with children, remember to do the following:

Never leave infants, children or pets in a parked car, even if the windows are cracked open.

To remind yourself that a child is in the car, keep a stuffed animal in the car seat. When the child is buckled in, place the

stuffed animal in the front with the driver.

When leaving your car, check to be sure everyone is out of the car. Do not overlook any children who have fallen asleep

in the car.

Avoid Hot and Heavy Meals: They add heat to your body!

STAY HYDRATED

Drink Plenty of Fluids: Drink more fluids, regardless of how active you are. Don’t

wait until you’re thirsty to drink.

Warning: If your doctor limits the amount you drink or has you on water pills,

ask how much you should drink while the weather is hot.

Stay away from very sugary or alcoholic drinks—these actually cause you to

lose more body fluid. Also avoid very cold drinks, because they can cause

stomach cramps.

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Replace Salt and Minerals: Heavy sweating removes salt and minerals from the body that need to be replaced. A sports

drink can replace the salt and minerals you lose in sweat.

If you are on a low-salt diet, have diabetes, high blood pressure, or other chronic conditions, talk with your doctor

before drinking a sports beverage or taking salt tablets.

Keep Your Pets Hydrated: Provide plenty of fresh water for your pets, and leave the water in a shady area.

STAY INFORMED

Check for Updates: Check your local news for extreme heat alerts and safety tips and

to learn about any cooling shelters in your area.

Know the Signs: Learn the signs and symptoms of heat-related illnesses (below) and

how to treat them.

Use a Buddy System: When working in the heat, monitor the condition of your co-

workers and have someone do the same for you. Heat-induced illness can cause a per-

son to become confused or lose consciousness. If you are 65 years of age or older, have

a friend or relative call to check on you twice a day during a heat wave. If you know

someone in this age group, check on them at least twice a day.

Monitor Those at High Risk: Although anyone at any time can suffer from heat-related illness, some people are at greater

risk than others:

Infants and young children

People 65 years of age or older

People who are overweight

People who overexert during work or exercise

People who are physically ill, especially with heart disease or high blood pressure, or who take certain medications, such

as for depression, insomnia, or poor circulation

Visit adults at risk at least twice a day and closely watch them for signs of heat exhaustion or heat stroke. Infants and young

children, of course, need much more frequent watching.

Heat-related illness What to look for What to do

Heat stroke High body temperature (103°F or higher) Hot, red, dry, or damp skin Headache Feeling dizzy Nausea Feeling confused Losing consciousness (passing out)

Call 911 right away- heat stroke is a medical emergency

Move the person to a cooler place Help lower the person’s temperature with cool cloths or a

cool bath Do not give the person anything to drink

Heat exhaustion Heavy sweating Cold, pale, and clammy skin Fast, weak pulse Nausea or vomiting Muscle cramps Feeling tired or weak Feeling dizzy Headache Fainting (passing out)

Move to a cool place Loosen your clothes Put cool, we t cloths on your body or take a cool bath Sip water Get medical help right away if: You are throwing up Your symptoms get worse Your symptoms last longer than 1 hour

Heat cramps Heavy sweating during intense exercise Muscle pain or spasms

Stop physical activity and move to cool place Drink water or a sports drink Wait for cramps to go away before you do any more

physical activity Get medical help right away it: Cramps last longer than 1 hour You’re on a low-sodium diet You have heart problems

Sunburn Painful, red, and warm skin Blisters on the skin

Stay out of the sun until your sunburn heals Put cool cloths on the sunburned areas or take a cool bath Put moisturizing lotion on sunburned areas Do not break blisters

Heat rash Red clusters of small blisters that look like pimples on the skin (usually on the neck, chest, groin, or in elbow creases)

Stay in a cool, dry place Keep the rash dry Use powder (like baby powder) to soothe the rash

For more information, visit: https://www.cdc.gov/disasters/extremeheat/heattips.html last updated (June 19, 2017)

6 6

For more information, visit: https://www.cdc.gov/foodsafety/communication/steps-healthy-fruits-veggies.html last updated (August 8, 2016)

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Creole Tomato Salad

4 servings

INGREDIENTS

Salad:

3 ripe tomatoes, cut into 1/4-inch-thick slices (about 2

pounds)

1 Vidalia or other sweet onion, thinly sliced and separated

into rings

1/4 teaspoon salt

1 tablespoon thinly sliced fresh mint

2 teaspoons chopped fresh chives

Vinaigrette:

4 teaspoons olive oil

4 teaspoons red wine vinegar

1 teaspoon Dijon mustard

1/2 teaspoon minced fresh garlic

DIRECTIONS

1. Combine oil, vinegar, mustard, and garlic in a jar.

2. Cover tightly; shake vigorously.

3. Alternate tomato and onion slices on a platter.

4. Sprinkle with salt and top with mint and chives.

5. Drizzle vinaigrette over salad.

6. Serve at room temperature.

Green Beans with Lemon and Garlic

6 servings

INGREDIENTS

2 cups water

1 1/2 pounds green beans, trimmed

1 1/2 tablespoons olive oil

1 1/2 tablespoons butter

1 garlic clove, minced

2 tablespoons fresh lemon juice

1/4 teaspoon salt

1/4 teaspoon freshly ground black pepper

2 tablespoons chopped fresh parsley

DIRECTIONS

1. Bring water to a boil in a large skillet.

2. Add beans; cover, reduce heat, and simmer for 8 minutes

or until tender.

3. Drain beans; pat dry.

4. Heat oil and butter in pan over medium heat.

5. Add garlic, and sauté 30 seconds.

6. Add beans, juice, salt, and pepper; cook 2 minutes or until

thoroughly heated.

7. Sprinkle with parsley.

Seared Tuna with Avocado Salsa

4 Servings (serving size: 1 tuna steak and about 1/3 cup salsa)

INGREDIENTS

1 cup halved grape tomatoes

1/2 cup vertically sliced red onion

3 tablespoons chopped fresh cilantro

2 tablespoons fresh lime juice

3/8 teaspoon salt

1/2 teaspoon freshly ground black pepper

2 avocados, peeled and diced

2 garlic cloves, minced

1 jalapeño pepper, seeded and finely chopped

2 tablespoons lower-sodium soy sauce

2 teaspoons dark brown sugar

Cooking spray

4 (6-ounce) tuna steaks

DIRECTIONS

1. Combine first 9 ingredients in a medium bowl.

2. Combine soy sauce and brown sugar in a small bowl,

stirring until brown sugar dissolves. Reserve 1 tablespoon

soy sauce mixture.

3. Heat a grill pan over high heat. Coat pan evenly with

cooking spray.

4. Add steaks to pan; cook 2 minutes on each side or until

desired degree of doneness, basting steaks frequently with

soy mixture. Remove steaks from grill pan; drizzle with

reserved 1 tablespoon soy mixture.

5. Serve fish with salsa.

Crab and Heirloom Tomato Salad

4 Servings (serving size: 3/4 cup crab mixture and about 1 cup

tomato)

INGREDIENTS

1/3 cup fresh cilantro leaves

4 mini sweet bell peppers, thinly diagonally sliced

1 large shallot, thinly sliced

1 jalapeño pepper, thinly diagonally sliced

12 ounces jumbo lump crabmeat, shell pieces removed

2 1/2 tablespoons canola mayonnaise

1 teaspoon grated lime rind

1 tablespoon fresh lime juice

2 pounds heirloom tomatoes, sliced

1 1/2 tablespoons extra-virgin olive oil

1/4 teaspoon kosher salt

1/4 teaspoon freshly ground black pepper

1/4 cup small fresh basil leaves

DIRECTIONS

1. Combine the first 5 ingredients in a large bowl.

2. Combine mayonnaise, rind, and juice in a small bowl,

stirring with a whisk.

3. Add mayonnaise mixture to crab mixture; toss gently to

coat.

4. Arrange tomatoes on a serving platter; drizzle with oil and

sprinkle with salt and pepper.

5. Mound crab mixture over tomatoes and sprinkle with basil

leaves.

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StoneSprings Hospital Center’s mission is delivering exceptional care - every patient, every time.

Conveniently located on Route 50 in Loudoun County, our hospital includes a 124-bed acute care medical and

surgical facility, 24-hour emergency care, and top-quality professional expertise. As a vital member of the

HCA Healthcare System, we share the strength of more than 163 hospitals across the United States and

England. In addition, StoneSprings Hospital Center prides itself on community engagement - sponsoring

active health and wellness programs and

reduced-cost health screenings. Our values are

simple - integrity, compassion, accountability,

respect, and excellence.

Delivering Specialized Care to Inpatients

Just as a cardiologist is a physician who

specializes in treating heart patients, a

hospitalist is a physician who specializes in

caring for patients in the hospital. Primary care

physicians traditionally have had to balance

their time between seeing patients in the office

StoneSprings Hospital Center

High-Quality Health Care– Close To You.

9

and in the hospital, often visiting their

inpatients before or after office hours.

Today, StoneSprings Hospital Center

utilizes hospitalists to oversee patient care in

the hospital, working in close

communication with primary care

physicians.

Partnering With Primary Care Physicians

Primary care physicians still play an

important role in caring for patients while

they’re hospitalized and will receive regular

updates from our hospitalist regarding the

plan of care and progress.

Even if your patient is admitted to the hospital through the emergency room, our hospitalist will notify you

and discuss the condition and status of your patient. And if your patient needs specialized care while they're

hospitalized, our hospitalist team will coordinate the care with the appropriate specialists. When the patient is

discharged, our team will transition medical care back to you, providing detailed reports from your patient’s

visit, lab results, images and follow-up care recommendations to ensure continuity of care.

Our hospitalists are your advocates - ensuring

you receive timely, effective communication

from all the specialists who may need to consult

on your patient’s care.

How you Benefit

Our hospitalists are physicians with special

training in family, internal, pulmonary and

critical care medicine, providing the highest

level of inpatient care.

As key members of StoneSprings Hospital

Center's team, hospitalists have detailed

knowledge of specialists and procedures that lead to improved patient results.

Our physicians are compassionate and knowledgeable when it comes to answering questions and

explaining inpatient details such as discharge procedures to patients and their families.

Our experience and sole focus on caring for inpatients leads to faster, more accurate clinical decisions

made with a high degree of confidence. This results in better outcomes, shorter hospital stays and fewer

readmissions.

STONESPRINGS HOSPITAL CENTER

24440 STONE SPRINGS BLVD DULLES, VA 20166

571-349-4000

STONESPRINGSHOSPITAL.COM | LIKE US ON FACEBOOK TO LEARN MORE.

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A U S L T X Y D W A E Y J I K D E H E A Z P A N X B V E Y Y C U W B S Q

W I W U G T E Z N O G N F X Q P C E D Q O S U T W G R U T N G E P C E W

T Q R D D Z G U B U M N V O P V I J T T R H Y G T P R J T S G J I Z O H

Q J F D I U B X D C I T X D X N T L O D Q N G Q R E H O Y B Z R S Q Q F

O C C O N L A R G Q X V L G S C C M X A H P J M R H G L I F T D C W R I

H C K A R A S J C Y V S H X P N A V W B G L V B Y K A O I A W X I D F S

S C S H F S X S Z I B D U Z G C R R F O U P D J Y P E A I J H T R F A U

T G X N C G Q E O M W P F Z F D P T E F U N J I W C F D T D W H T J W G

E N Y U S W E M L S W J Q A N V Y E K I Y I J F I L E M J B S J A W M W

R A Q D I O M G B A K I M A A W L D R K N X F T F P D D R X A V I W K I

L Q N T U B E F J R F I M W R F I Q J A M T C A N V E J V G R W D P G X

I R V S I F Z P A F L O B B S B M U I T C A E R T R G Q N K X E E S U M

N W P I K M U W U Y V S S Q Z U A J H O R H U G V H P J J Z V Z P T G C

G J G Z D Q M J P F J W V E H W F M X P O B T W R G R D J D C A G V U Z

F C Q J Q Z M R Q T J N E E T C G L Y E H J N L T A A T Q N O T N B H I

A M X C F E A X Z E T Z O K N A N L V S Y O C Z A X T N W Z F A I J T H

M V C L D C C L F J V D Q T V Q I Y A V T U Y Q J E D I S B D Y L B B F

I T V L T H F Q Q B C V Y T L M L C R V Z G W Q V E H C V K D J R F D D

L C E I A F X U F A R D P W A K R R O C D O M X G S P C F E U C E T B Q

Y U C J M S V T Y S X N Y F G Z E G V S E K Q E D B L V I J H A T B W U

P E E G I M K C I Y S E Y O H T T X V C S S M C R E Q J Y R L E S X I X

R E D J E F F R E Y N E K O B A S W Z X A A A H H I Y B G V T Q A N X G

A R J E D A S O A R L H J F O G G T N O V N E W U M Y R F Z E A A L O E

C K L G L U U U A L J J M B E G R Z G V B Q M N B T O Z W T N L I O T L

T M T H R W N R A V T E W S O J U T G W F G V J I J D J I U Z M E D E H

I L R E J L G V T C G Z M F B J B B R N Y U E X A C X B C N S A F C E H

C S E N H Y N W L A T Y C R D V S O D N W E M E T A I L A J A J R M Y P

E B O F U U M P J N V Z D X Z Z E A P X M E R O G R A D C W I P Z T Q G

Q G Y F O J I X U J H G F B U Q E U O A X F S J O J B C E L C E H Q I E

I T P D R E J N U H R V N P N J L F T L Q O Q I I M F B G M P I J M U H

L O U D O U N P E D I A T R I C A S S O C I A T E S C S Z D Y R Z G K W

M O R E T N E C E R A C Y R A M I R P G M L C K O P C D E Q T L B X D M

L T Q V Y Y T Y S T I J Z G T M W H E Y J H S V I T N C A R E C I G H N

R V C Q A A D W I J P L H V J A B B G W I B C W T X N A O Y I E M M Z V

A Y Y B E I T E R R G F V O U H Y I L T R I E O K S S J Z D Y G T C A P

B O F T Z K X J J Z G F N V D Q E H S K X E W R Z J I M H T R D O N T F

Ashburn Pediatrics

Family Medicine

Associates of

Alexandria

Foxcare Integrative

Health

Jeffrey Nekoba, MD

Leesburg Sterling

Family Practice

LMG Primary Care Center

Loudoun Pediatric

Associates

Loudoun Valley Family

Practice

Pediatric Healthcare

Potomac Family Practice

Sterling Family

Practice

Sterling Pediatrics

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From the Doctor’s Desk

Featuring Dr. Melissa Delgado | LMG - Gynecology & Wellness Center

From the Doctor’s Desk

Chronic pelvic pain (CPP) is a very common and in many

cases debilitating medical issue. CPP is typically defined

as any pain lasting longer than 6 months and typically

causes pain in the lower abdomen, vulva, vagina, back and

hips. Sometimes pain will radiate down one or both legs.

CPP may include one or all the following: Endometriosis,

Interstitial Cystitis, Irritable Bowel Syndrome, Chronic

Vaginitis, Vulvodynia, Pelvic Floor Dysfunction, Anxiety

and Depression. A chronic pelvic pain specialist will be

able to diagnose and develop a comprehensive treatment

plan for each component of CPP with which the patient

presents.

Chronic pain differs from acute pain because chronic pain

persists and sometimes progresses for a long period.

Acute pain typically ends after an expected time frame.

Pain itself often modifies the way the central nervous

system works. The patient typically becomes more

sensitive to pain and sometimes may perceive more

intense pain or pain on a higher pain scale with less

provocation. This is referred to as “central sensitization”

because it involves changes in the central nervous

system (CNS): particularly the brain and spinal cord. It

has been recently found that structural and functional

changes occur in the CNS and are associated with many

chronic pain syndromes.

Endometriosis affects at least 6.3 million women and

girls in the United States. Endometriosis occurs when

tissue that belongs in the uterus grows outside the uterus.

The tissue responds as it does as if it were in the uterus.

This results in cyclical pain, which becomes progressively

worse.

Main symptoms of Endometriosis include:

Pain before and during periods

Painful intercourse

Infertility

Fatigue

Painful urination during periods

Painful bowel movements during periods

Other Gastrointestinal upsets such as diarrhea,

constipation, nausea.

What is it?

Chronic Pelvic Pain

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Interstitial Cystitis (IC)/Painful Bladder Syndrome

(PBS) affects 2.7- 6.5 % of women in the United States. IC

is a chronic inflammatory process that breaks down the

protective layer of the bladder and irritates the muscle layer

of the bladder.

Main symptoms of IC include:

Burning on urination, urgency, frequency (like that of a

urinary tract infection)

Pain

Painful intercourse

Feeling like the bladder is never empty

Waking up from sleep to urinate

Irritable Bowel Syndrome (IBS) affects about 10-15 % of

men and women in the United States.

IBS is most commonly characterized as chronic abdominal

pain with altered bowel habits.

Main symptoms and co-morbidities for Irritable Bowel

Syndrome include:

Abdominal pain

Abdominal cramping

Bloated/Gassy feeling

Gas (Flatulence)

Diarrhea

Constipation

Mucus in stools

Vulvodynia affects 8.3 % of women in the United States

and is characterized as vulvar pain. Recently there was a

consensus of terminology and classification of persistent

vulvar pain. This has helped to standardize how we talk

about vulvar pain, although the treatment plan will still

require time and medication to notice improvement of

symptoms.

Main symptoms of Vulvodynia include:

Burning

Soreness

Stinging

Rawness

Painful intercourse (dyspareunia)

Throbbing

Itching

Pelvic Floor Dysfunction (PFD) is noted when the group of

muscles in the pelvis become less functional. These group of

muscles are designed to support the organs in the pelvis such

as the bladder, uterus and rectum.

Main symptoms of PFD include:

The feeling that you need to have several bowel

movements during a short period of time.

The feeling that you cannot complete a bowel

movement.

Constipation or straining pain with bowel movements.

A frequent need to urinate. When you do go, you may

stop and start many times.

Painful urination.

Pain in your lower back that cannot be explained by

other causes.

Ongoing pain in your pelvic region, genitals, or rectum.

Pain for women during intercourse.

Anxiety and Depression may result as pain progresses and

CNS changes start to occur. Often, patients may not have

had a history of either anxiety or depression and now find

themselves requiring medication to help control the levels of

anxiety and/or depression. Those with anxiety and/or

depression may find their symptoms have increased or are

less manageable with their current medication dose. Others

may not want to approach this topic with their physicians

because they may not understand why they feel this way.

Chronic pelvic pain is complex for both physicians and

patients, and requires a team approach and active

participation by the patient. Chronic pelvic pain requires

making the correct diagnosis of all conditions involved and

managing and optimizing each disease process. Time is also

a huge component to the healing process, and may be very

frustrating to the patient who has already been suffering with

CPP for many years. Finding a team fluent in working with

chronic pelvic pain is essential to make the healing process

successful.

Visit www.gynwellnesscenter.com

or call 703-448-6070 to reach

Dr. Delgado and the experts at

Gynecology & Wellness Center

Gynecology & Wellness

Center

8292-C Old Courthouse Rd

Vienna, VA 22182

14

LMG IT B y C o r e y P e r l o f f , D i r e c t o r o f I T

Questions or comments contact us: helpdesk@lmgdoctors.com or call 703-636-4437

Physical Security Protection:

In the last LMG Newsletter, we wrote about Social Engineering. This is a

continuation of that article with an emphasis in regards to on-site Social

Engineering. We have all seen the movies where the criminal dresses up like the

Cable Guy and pretends he is there to fix something so he can gain access to the

IT Room.

Unfortunately, this is based on reality. There have been cases whereby the hacker

will dress up as a phone or cable technician and report to the front desk and say,

“I’m with the IT Department”. The hacker may walk back and start using a

computer or ask to be escorted to the IT Room so they can “work” on the wiring,

or some other connection issue.

Within minutes an attacker can plug a USB device into a computer and quickly steal your credentials, your data, and

have control of your computer from an external source when he leaves your office.

Hacker’s may also leave behind a USB drive, or other storage device in an office with a tempting label on it. Often times,

if someone finds a USB drive, they’ll be tempted to plug it in and use it as their own. Just plugging it in or opening a file

with an enticing name could launch malicious code.

What’s the root cause of these hacks? People. Hackers use social engineering attacks to take advantage of the “faults” in

humanity, our human emotions and feelings, to get access to a technical resource.

User awareness is by far the most important aspect to security. Employees need to be made

aware that strangers cannot be in the office without an escort. All employees should

confront and ask an unidentified individual if they need any assistance. Ask to see an

Identification Badge prior to letting anyone access any IT room, or office equipment.

Without strong physical security, an organization can spend thousands of dollars on anti-

virus software, firewalls, and intrusion prevention systems only to have confidential data

stolen by a careless error. Many organizations underestimate the importance of keeping

their offices and their equipment physically secure.

Common sense is your best defense. Most data breaches could have been prevented. If

something seems suspicious or does not feel right, it could be an attack of some kind.

Modern day hackers have shifted away from systems as the target and moved to

individuals.

Notify the LMG IT Department immediately of any suspected incidents.

If you suspect someone is trying to trick or fool you, do not communicate with

that person anymore. If the attack is work related, be sure to report it to the

Helpdesk right away.

“Can I See Your

Badge?”

All LMG IT/EMR

Department employees

are now required to

carry an ID Badge.

(Sample Below)

Protecting Yourself

15

EMR Team

Lesha Malam Electronic Health Record

Manager

Jackie Thomas Population Health

Implementation Manager/EMR

Lisa Cantrell Implementation Specialist

Mandy Shain Implementation Specialist

Alex Torres Implementation Specialist

David Bolton Implementation Specialist

Chuck Boyd Implementation Specialist

Hazim Salem Implementation Specialist

Nathan Crowley Implementation Specialist

EMR NEWS CORNER

Contacting the EMR Helpdesk

EMR Email: EMRHelpdesk@lmgdoctors.com

Phone: 703-636-4438

Remember to include the following:

Your name

Name of Office (i.e. LSFP)

Location of Office (i.e. Purcellville)

Nature of the issue

A good contact number - if after your hours

or during lunch, you must leave a backline

number to reach you

EMR Update – Summer 2017

The summer has started off on a busy note for the EMR department.

We have been holding weekly adult medicine and pediatric sub-

committee meetings and in-office provider meetings, to review

many of the templates that will be used within eClinicalWorks.

These sessions are designed to set a standard for the well/physical

visits, as well as diseases processes in which we are measured for

our quality of care, such as diabetes and hypertension.

All practices currently using Pulse EMR will transition to

eClinicalWorks on Monday, September 18. In preparation for the

go-live, we will begin training in late July. These training sessions

will take place at each office and will be scheduled through the

office manager. If you are unable to attend your scheduled training

session, need additional assistance, or have more questions, we will

be hosting additional training classes in the evenings and on

Saturdays. Office managers will have a complete schedule of all

classes prior to the end of June. We are also completing videos that

will be available to watch in conjunction with the scheduled office

training for additional questions and how-to’s.

We look forward to seeing you for training and a successful

eClinicalWorks go-live on September 18!

16

LMG Human Resources

How well do you understand the LMG 401k Retirement Savings Plan?

LMG is Investing in our Employees with

Profit Sharing!

LMG contributes to the 401k plan via profit sharing. Under LMG

Profit Sharing, a percentage of your eligible income is deposited into

your Vanguard LMG 401k Retirement Savings Plan each year. This

is our way of sharing the success of the organization with our

employees.

Profit Sharing Eligibility:

One year of service

Worked at least 1,000 hours in the profit sharing year

Actively employed on December 31 of the profit sharing year

Employees do not need to contribute to the 401k plan in order to be

eligible for profit sharing. LMG will make a Profit Sharing

contribution to all employees who meet the eligibility criteria. All

profit sharing contributions must be distributed into an employee’s

LMG 401k plan.

You become eligible for profit sharing contributions on the first day of the quarter following your one year anniversary.

Profit Sharing Contributions

Years of Service Percentage

Less than 2 0%

2 20%

3 40%

4 60%

5 80%

6 100%

HIRE DATE: July 2, 2012

ONE YEAR ANNIVERSARY: July 2, 2013

YOU BECOME ELIGIBLE FOR

PROFIT SHARING PROGRAM: October 1, 2013 (1st of quarter following one year anniversary)

*ELIGIBLE COMPENSATION: All income earned between 1st paycheck dated in October 2013 through last

pay check in 2013.

If your *eligible compensation between October 1 and December 31 was $10,000 and the profit sharing contribution in 2013

was 3%, LMG will deposit $300 deposited into your 401k plan.

If your *eligible compensation between October 1, 2013 and December 31, 2013 was $60,000 and the profit sharing

contribution in 2013 was 3%, LMG will deposit $1,800 into your 401k plan.

LMG determines Profit Sharing

contribution for the prior year March

LMG makes contributions to

employee 401k accounts in lump

sum or over several installments

Between April and

September

Vesting Schedule

You are always 100% vested in your own contributions.

There is a vesting schedule for Profit Sharing Contributions

that is based on years of service.

LMG reviews profit sharing figures each year to determine

what the company will be able to provide to employees

through profit sharing. Profit Sharing distributions are

determined during the first quarter of the following year and

distributions are deposited into employee 401k accounts by

September of the following year.

EXAMPLE

17

Extraordinary Care from Exceptional

Employees!

Join LMG…A great place for care and a great

place to work!

Looking to work for one of the largest and most diverse physician-owned, multi-specialty group practices in

Virginia? LMG is always looking for great candidates to fill positons in our many practice groups with locations

from Alexandria to Berryville, Virginia.

For more information on what positions are currently open within LMG please visit our website at

www.lmgdoctors.com. Submit your resumes today at resumes@lmgdoctors.com.

Accessing your LMG 401k Account:

LMG employees may elect to change their 401k elections at any

time. You can start, stop or change your payroll contributions

or make changes to your fund allocations. You can even direct

or redirect your contributions from traditional pre-tax to Roth

after-tax contributions.

Online. Register now at vanguard.com/register to check your

balance, conduct transactions, research investments, use

financial planning tools, and more. You will need your plan

number to sign up: 097553.* Fund and expense information is

also available at https://retirementplans.vanguard.com/

PubFundChart/loudoun/2348

By phone. Call the 24-hour interactive VOICE® Network at

800-523-1188. You will need a personal identification number

(PIN) to use VOICE. To create a PIN, follow the prompts.

On Your Mobile Device Go to vanguard.com/bemobile to download the Vanguard app so you can access your account on

the go.

With personal assistance. Vanguard Participant Services associates are available to assist you at 800-523-1188 Monday through

Friday from 8:30 a.m. to 9 p.m., Eastern time.

*Maximum annual contribution includes both pre-tax and after-tax (Roth) contributions.

Minimum Contribution Per Pay Maximum Contribution Per Pay Max Annual Contribution

$10 or 1% 100% of pay $18,000* < age 55 $24,000* >/= age 55

Retirement

18

LMG Wellness and Weight Loss Center

At LMG Wellness, we care about changing your

lifestyle and promoting wellness through nutritional

education. By using a medically developed diet

program that focuses on weight loss and education

that concentrates on eating smarter, weight loss

counselors will help you through obstacles and keep

you focused throughout the duration of your weight

loss journey. You will receive weekly one-on-one

support from your personal coach, as well as daily

video support from Ideal Coaching TV.

Our program offers over 80 flavors of meals to be

enjoyed alongside a wide variety of vegetables, and

protein options.

In 2016 our dieters lost a total of 2,729.4 lbs!

For more information about the program or for a

schedule of upcoming informational workshops,

contact our weight loss coach Thurza Hay at

571-289-3238, or send her an email at

LMGweightloss@lmgdoctors.com

LMG is a proud sponsor of the:

19

PROVIDERS: ARE YOU TAKING ADVANTAGE OF THE CHRONIC CARE

MANAGEMENT (CCM) BENEFIT?

Tip your cap to the many providers who found success in the first year of chronic care

management (CCM), but also take a hard look at your CCM potential — you may be

leaving money on the table for services you already provide.

That may be especially true for 2017 reporting, because CMS added two codes —

99487 and 99489, which are time-based complex CCM codes — to the care

management category and also cut back the reporting burden for the CCM

codes. Complex CCM code 99487 requires 60 minutes of care management services per

month and pays about $94, while 99489 is a 30-minute add-on code and pays an

additional $47.

Across the board, providers submitted more than 1 million claims for 99490 in the

code’s debut year of 2015, returning $31.3 million in payment and executing new service

requirements to reap a 94% claims acceptance rate, according to 2015 Medicare data, the

latest available claims data.

Among E/M codes, the 5.7% denial rate for CCM claims lands on the low end of the

spectrum. But that shouldn’t come as a complete surprise. Billing limitations [for CCM]

set forth by CMS are very clear and easy to understand, so it is expected to be a very low

denial rate.

Yet the general feeling is that CCM remains underused. About 560,000 unique patients

received CCM services since 99490 debuted in 2015, according to estimates from CMS in final 2017 Medicare physician

fee schedule. That comprises a small slice of the roughly 35 million patients who meet eligibility requirements according

to the American College of Physicians.

Track patient interactions to code successfully

Because CCM is not your typical fee-for-service code, perhaps the slow uptake should be expected. While the billing

requirements are straightforward, the system used to track patient interactions differs from traditional E/M codes — and

that can lead to hesitation.

Some providers have found success by adopting CCM-specific workflows. The common thread of successful CCM

adoption is having an easy workflow and following it for each and every patient. Having a system is the key to

capturing these charges.

Internal medicine, primary care lead the pack

Internal medicine and primary care providers reported the bulk of 99490 claims in 2015, accounting for 78% of total

claims submissions, or about 820,000 claims out of the total 1 million. Dozens of other specialties got into the game as

well, with cardiology, general practice, rheumatology and geriatric medicine all reporting at least 10,000 claims in 2015.

CMS cut out some of the reporting requirements for 99490, as of Jan 1. For example, practices no longer are required to

have the patient sign a beneficiary consent form and don’t need to provide access to the electronic plan of care around

the clock. That may lead to more providers jumping on board and taking advantage of these additional benefits.

Manager:

Corella Lumpkins

clumpkins@lmgdoctors.com

703-737-6010 ext. 6153

Coding Specialist:

Mona Mahajan

mmahajan@lmgdoctors.com

703-737-6035

Coding Assistant:

Natalie Garbes

ngarbes@lmgdoctors.com

703-737-6010 ext. 6115

Coding

Department

Contacts:

LMG Coding Update

20

PLEASE

PLACE

STAMP

HERE

STAY CONNECTED WITH US!

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linkedin.com/company/loudoun-medical-group www.lmgdoctors.com

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224D Cornwall Street, NW

Suite 403

Leesburg, VA 20176

Phone: 703.737.6001

Fax: 703.443.8697

Email: Info@LMGDoctors.com

Loudoun Medical Group Management

Mary Beth Tamasy Chief Executive Officer 703-737-6006

Ross Taylor Regional Director of Operations 703-737-6008

Matt Cubbage Regional Director of Operations 703-737-6029

Gary Rothstein Regional Director of Operations 703-737-6010 x 6180

Jeannette Koene Regional Director of Operations 703-737-6001 x 6201

Clara Nussbaum Quality Director 703-737-6003

Maggie Colucci Director of Human Resources 703-737-6033

Corey Perloff Director of EHR & IT 703-737-6011

Lesha Malam Electronic Health Record Manager 703-737-6023

Corella Lumpkins Coding Compliance Manager 703-737-6010 x 6153

Gary Armstrong Finance 703-737-6001 x 6114

Parker Posey Operations Support Manager 703-737-6010 x 6122

Dustin Smith Operations Support Manager 703-737-6155

Marketa Zmeskalova Operations Support Manager 703-737-6001 x 6202

Heather Stanton Credentialing Manager 703-737-6012

Kathy Stephens CBO Manager 703-737-6001 x 6127

Beverly Stickel Lockbox Manager 703-737-6001 x 6140

Sharon Emerald Nurse Care Coordinator Manager 574-209-1852

Sheri Gazes Marketing 703-737-6001 x 6121

Carrie Start Marketing 703-737-6001 x 6156

The Town of Leesburg’s annual Flower and Garden Festival took place April 22nd and 23rd this year. It was the 27th year the town has held this

fantastic event and LMG’s 5th year as presenting sponsor. While the festival kicked off with rainy cold day Saturday, the weather turned around on

Sunday and the sun broke through bringing droves of people to Leesburg’s historic downtown.

This is a very exciting and fun event for LMG. It’s allows clinicians and office staff to interact with our patients and the public in a non-clinical

setting. Festival goers were provided with free blood pressure screenings, recommendations for primary and specialty care providers, and a chance

to meet some of the LMG providers that were in attendance. Not only that, but the ever popular prize wheel was back, stalked with many fun

prizes. Many larger items were also raffled off, including a kayak, composter, his and hers bicycles, and a tailgating grill.

The annual Flower and Garden Festival is more than just a “garden show,” it is a place for the community to come together for a weekend of fun

and entertainment, and Loudoun Medical Group is proud to support and make that possible.

Special “Thank You” to our Practices that participated:

Ashburn Sterling Internal Medicine &

Pediatrics

Catoctin Foot and Ankle

Dr. Matthew Gavin

Dulles Medical Group

Leesburg Sterling Family Practice

LMG Primary & Immediate Care

Center

LMG Wellness & Weight Loss Center

Loudoun Medical Care & Wellness

Loudoun Pediatric Associates

Loudoun Spine and Rehabilitation

Optimum Physical Therapy

Pediatric Healthcare

Potomac Family Practice

The Urology Group

United Spine Center