Month: June 2016

[ad_1]

Kyoto is the capital city of Kyoto Prefecture and a major part of Osaka-Kobe-Kyoto metropolitan area. Formerly, the imperial capital of Japan, Kyoto has a population close to 1.5 million and geographically located in the central part of the island of Honshu, Japan. This paper lists the best of the best hospitals available within Kyoto city, suitable for foreign visitors.

A list of top 5 hospitals providing services which are absolutely suitable for foreigners are listed below. The list includes the addresses of the hospitals along with the facilities the hospitals provide. For the safety of the visitors, it is strongly advised to have the list with every foreign visitor who visits Kyoto as this helps a lot in case of medical emergency.

The Kyoto University Hospital is considered to be one of the most prominent hospitals in the city providing proper diagnosis followed by effective treatments and medicines. Located at Ohtsu, Shiga, the hospital offers proper nursing and effective care along with the well-being of the patients. This hospital also provides modern cancer and tumor treatments. The hospital claims that it has performed successful liver transplantation and regeneration of blood vessel by using human embryo stem cells. The various medical departments include general medicine, internal medicine, ophthalmology, surgery, neurosurgery, dermatology, plastic surgery, orthopedic surgery, pediatrics, radiology, urology, cardiovascular surgery, psychiatry, physical therapeutics, nutrition, gastroenterological endoscopy and more. Many doctors are able to speak foreign languages ​​too thereby enabling the patients to understand and communicate better. They strongly say that they can easily understand the difference between patient expectations and its perception of patient expectations and hence they will be in a better position to differentiate their perceptions of patient's expectations and thereby offer a better quality of service.

Japan Baptist Hospital in Kyoto carries the treatments in a most unique way. Patients are treated here as creations of God. Located at Kitashirakawa, Sakyo-ku, extraordinary special and minute care is taken for the physical and spiritual well-being of the patients. They call this process as Whole Person Healing. A detailed understanding of the human nature and the nature of diseases are carried out with perfect dedication and warmth by highly qualified professional doctors and efficient nurses.

Kyoto Prefectural Medical University Hospital is considered to be another significant hospital in the city. Located at Kawaramachi-dori, Kamigyo-ku, this hospital claims to provide the best of the best services available within the city. They also claim to offer treatment to AIDS.

Kyoto City Hospital provides treatments and facilities like internal medicine, surgery, orthopedics, pediatrics, radiology, urology, anesthesiology, gynecology, otorhinolarynogology, dermatology and ophthalmology. Located at Mibu, Nakagyo-ku, this hospital claims to offer top quality services.

Kyoto First Red Cross Hospital is located at Higashiyama-ku offering various levels of services to its patients. They primarily focus on monitoring the difference between the service quality specifications and the actual service delivered which helps to upgrade as and when needed. The management is keen in observing the difference between the service delivery and the essence of what is communicated to their patients and their services. By understanding the patient's perceptions of service quality, the hospital displays a sense of reliability, responsiveness, empathy and assurance to the patients.

Hopefully, nothing will go wrong on your trip to Kyoto. However, just in case you have an accident or fall ill, you now have some ideas where to go for good medical care.

[ad_2]

Source by Belle Kay

[ad_1]

The healthcare field is the subject of a host of federal statutes, regulations, guidelines, interpretive information, and model guidance. There are a considerable number of statutes and regulations that have an impact on the delivery of healthcare services. A statute is legislative enactment that has been signed into law. A statute either directs someone to take action, grants authority to act in certain situations, or to refrain from doing so. Statutes are not self-enforcing. Someone must be authorized to do so to take action. A statute may authorize the Department of Health and Human Services to take action, and it is up to the department to implement the law. Regulations, or rules, are made by administrative personnel to whom legislatures have delegated such responsibilities. It is a tool for developing policies, procedures, and practice routines that track the expectations of regulatory agencies and departments. The statutory and regulatory requirements are subject to judicial interpretation.

A very important element of healthcare management is to understand the key regulatory environment. One government statute that effects patient healthcare is the Anti-Kickback Statute. The Medicare and Medicaid Patient Protection Act of 1987 (the "Anti-Kickback Statute"), has been enacted to prevent healthcare providers from inappropriately profiting from referrals. The government regards any type of incentive for a referral as a potential violation of this law because the opportunity to reap financial benefits may tempt providers to make referrals that are not medically necessary, thereby driving up healthcare costs and potentially putting patient's health at risk. The Anti-Kickback statute is a criminal statute. Originally enacted almost 30 years ago, the statute prohibits any knowing or willful solicitation or acceptance of any type of remuneration to induce referrals for health services that are reimbursable by the Federal government. For example, a provider may not routinely waive a patient's co-payment or deductible. The government would view this as an inducement for the patient to choose the provider for reasons other than medical benefit. While these prohibitions originally were limited to services reimbursed by the Medicare or Medicaid programs, recent legislation expanded the statute's reach to any Federal healthcare program. Because the Anti-Kickback statute is a criminal statute, violations of it are considered felonies, with criminal penalties of up to $ 25,000 in fines and five years in prison. Routinely waiving copayments and deductibles violates the statute and ordinarily results in a sanction. However, a safe harbor has been created wherein a provider granting such a waiver based on a patient's financial need would not be sanctioned. The enactment of the 1996 Health Insurance Portability and Accountability Act (HIPAA) added another level of complexity to the Anti-Kickback statute and its accompanying safe harbors. HIPAA mandated that the OIG (Office of Inspector General) furnish advisory opinions to requesting providers that are either in an arrangement or contemplating an arrangement that may not fit squarely within the law. For a fee, the OIG would analyze the arrangement and determine whether it could violate the law and whether the OIG would impose sanctions on the arrangement. In many of its advisory opinions published over the past few years, the OIG has stated that it would not impose sanctions, even though it found that the arrangement in question could violate the statute. A common reason the OIG has given for not imposing sanctions has been that the arrangement provides an overall benefit to the community. Healthcare finance professionals need to ensure that all business transactions comply with the Anti-Kickback statute.

The Anti-Kickback statute effects the patient. The main aim of this statute is to improve patient safety, provide satisfaction and avoid risk. The result of the acquisition of a physician's practice would serve to interfere with the physician's subsequent judgment of what is the most appropriate care for a patient. It would also interfere with a beneficiary's freedom of choice of providers.

Physicians have direct patient care responsibilities. Any incentive payments to such physicians that are either tied to overall costs of patient treatment or based on a patient's length of stay could reduce patient services. Also, the profits generated by cost savings may induce investor-physicians to reduce services to patients. Health care programs operate on the good faith and honesty of health care providers. It is important to ensure that quality services are provided at the hospital. The Anti-Kickback statute helps the government not to tolerate misuse of the reimbursement systems for financial gain and hold the responsible parties accountable for their conduct. Such conducts can also prompt patient complaints. The hospitals and physicians who are interested in structuring gainsharing arrangements might adversely affect patient care.

The Anti-Kickback statute creates a protective umbrella, a zone in which patients are protected so that the best health care is provided. This statute helps to improve efficiency, improve quality of care, and provide better information for patients and physicians. The Anti-Kickback statute is not only a criminal prohibition against payments made purposefully to induce or reward the referral or generation of Federal health care business, it also addresses the offer or payment of anything of value in return for purchasing, leasing, ordering of any item or service reimbursable in whole or part by a Federal health care program. It helps to promote quality and efficient delivery of health care transparency regarding health care quality and price.

There are millions of uninsured patients who are unable to pay their hospital bills. Giving a discount on hospital charges to an uninsured patient does not implicate the Federal Anti-Kickback statute. Most need-based discounting policies are aimed at making health care more affordable for the millions of uninsured citizens who are not referral sources for the hospital. For discounts offered to these uninsured patients, the Anti-Kickback statute simply does not apply. It is fully supported that a patient's financial need is not a barrier to health care. Furthermore, OIG legal authorities permit hospitals and others to offer bonafide discounts to uninsured patients and to Medicare or Medicaid beneficiaries who can not afford their health care bills. The Anti-Kickback statute is concerned about improper financial incentives that often lead to abuses, such as overutilization, increased program costs, corruption of medical-decision making, and unfair competition.

There are risk management implications of this statute. There are risks associated with the Anti-Kickback statute and its good to prevent them. Rather than be an imposing and daunting challenge to understand, the outcome can be development of risk management systems to guide the delivery of health care. This fact is recognized that such statutes are an important attribute of the risk management professional. For example there are potential risks under the Anti-Kickback statute arising from hospital relationships. In case of joint ventures there has been a long-standing concern about arrangements between those in a position to refer or generate Federal health care program business and those providing items or services reimbursable by Federal health care programs. In the context of joint ventures, the chief concern is that remuneration from a joint venture might be a disguised payment for past or future referrals to the venture or to one or more of its participants. The risk management should be done by having a knowledge of the manner in which joint venture participants are selected and retained, the manner in which the joint venture is structured and the manner in which the investments are financed and profits are distributed. Another area of ​​risk is the hospital's compensation arrangements with physicians. Although many compensation arrangements are legitimate business arrangements, but may violate the Anti-Kickback statute if one purpose of the arrangement is to compensate physicians for past or future referrals. Risk management is to follow the general rule of thumb that any remuneration flowing between hospitals and physicians should be at fair market value for actual and necessary items furnished or services.

Risk management is also needed in entities such as in cases where a hospital is the referral source for other providers or suppliers. It would be prudent for the hospital to scrutinize carefully any remuneration flowing to the hospital from the provider or supplier to ensure compliance with the Anti-Kickback statute. Also, many hospitals provide incentives to recruit a physician or other health care professional to join the hospital's medical staff and provide medical services to the surrounding community. When used to bring needed physicians to an underserved community, these arrangements can benefit patients. However, recruitment arrangements pose substantial fraud and abuse risk. This can be prevented by having knowledge of the size and value of the recruitment benefit, the duration of payout of the recruitment benefit, the practice of the existing physician and the need for the recruitment. Another area where risk management is to be applied is when the discounts are given. The Anti-Kickback statute contains an exception for discounts offered to customers that submit claims to the Federal health care programs. The discounts should be properly disclosed and accurately reported. The regulation provides that the discount must be given at the time of sale or, in certain cases, it should be set at the time of sale. This will help in risk management. It is also needed in medical staff credentialing and malpractice insurance subsidies.

The key areas of potential risk under the Federal Anti-Kickback statute also arise from pharmaceutical manufacturer relationships with 3 groups: purchasers, physicians or other health care professionals, and sales agents. Activities that pose potential risk include discounts and other terms of sale offered to purchasers, product conversion, consulting and advisory payments. The pharmaceutical manufacturers and their employees and agents should be aware of the constraints the Anti-Kickback statute places on the marketing and promoting of products paid for by federal and state health care programs. To that end, the draft guidance recommends pharmaceutical manufacturers ensure that such activities fit squarely within one of the safe harbors under the Anti-Kickback statute. The Department of Health and Human Services has promulgated safe harbor regulations that protect certain specified arrangements from prosecution under the Anti-Kickback Statute.

Healthcare being one the most regulated of all sectors of commerce, it is important that all facts and circumstances with respect to the statutes and regulations are evaluated.

[ad_2]

Source by Meenu Arora Kapur

[ad_1]

Preregistration – The medical billing process begins at the point of contact from the prospective patient. Preregistration is the first step in the Medical billing process and the revenue cycle. It is the time to gather demographic and insurance information. This information is vital to the successful adjudication of your medical claims and vital to the financial success of your practice. This step in the billing process has several front end processes. Failure to address these front end processes can and will cost your practice time and money.

Demographics – Demographic information is the patient's personal information. It includes the patient name, address, phone number, and work phone number, date of birth, gender and social security number. This information will be important when communicating with the insurance company for claims follow up and future contact with the patient. Demographic information is personal and needs to be protected in order to comply with HIPAA (Health Insurance Portability and Accountability Act) rules and regulations.

Insurance Information – The preregistration step is also the time to gather insurance information. Since this is how your practice will get paid for its services, it is worth taking extra time at this front end process and make certain this information is captured accurately. The name of the insurance company, the name of the insured if the insured is not the patient, type of policy, the ID number and the phone number for the insurance company are critical pieces of information. If you can obtain the mailing address for claims, it would be advantageous to do so at this time. Each piece of insurance information is vital to successful adjudication of the claim.

Compliance with insurance company policies – By obtaining the insurance information before your patient arrives for their first appointment, your practice will be able to verify eligibility and benefits, obtain the required authorization, obtain proper referrals and verify co pay and deductible information. The following information is critical to the billing and collections process and to the success of your practice. I want to stress that it is of the utmost importance to the practice for this information to be accurate. Failures to obtain proper referrals, precertification or preauthorization are all causes for denied claims. Collecting the co pay at the time of visit will save you the cost of printing a statement, envelope and postage and also the man hours to do follow up on a ten dollar balance.

Be Precise and Accurate – Since your staff has taken the time to obtain the demographic and insurance information, they should also take the time to enter this information accurately into you computer system. A couple of extra minutes spent on entering this information correctly will save time and money trying to fix mistakes and re-submitting rejected or denied claims. It is frustrating to say the least for a claim to be rejected or denied because of an incorrect digit in an id number or a patient name that is misspelled.

The cost of inaccurate information – Inaccurate demographic and insurance information is costly to your practice. It leads to rejected and denied claims. When claims are rejected or denied, it takes time or man-hours to research the denial reason, correct the inaccurate information and resubmit the claim. Inaccurate information leads to increase labor and resources to adjudicate the claim and delays the cash flow of your practice. It substantially can impact you bottom line.

[ad_2]

Source by Samuel D. Deutscher

[ad_1]

If you are worried about the skin on your face making you look older, then you may be able to take steps to smooth your skin and make yourself look younger. One of the procedures that you may be interested in is having Derma Filler injections to try to smooth out your wrinkles. There are a number of different types of injections which you can have, including Perlane and Juvederm Ultra XC. None of the types of injections is perfectly risk free, but all of the injections available offer some wonderful rewards for those who choose to try them.

The risks
The average cost of Derma Filler injections in the USA is $ 950 dollars around. Depending on which areas need to be filled, the prices can be much higher or much lower than this. Because most health insurance companies see these injections as cosmetic procedures, they will not normally cover the process with insurance funds, and therefore more candidates will have to self-fund their injections.

In terms of health, there are no major risks associated with having Derma Filler injections, although side effects will always depend on the individual, as with all medication. Many people report mild discomfort such as a stinging feeling or a tingling feeling whilst the injections are actually taking place, but these feelings usually disappear shortly after the injections have finished. Many experts will numb the area with a weak anaesthetic before the procedure, so that this discomfort does not cause problems. Some other users do experience headaches for a short period afterwards, if they have had injections around the forehead area, however these headaches can be easily treated with standard pain medication from any drugs store. Some people will also experience swelling, redness or bruising around the area for a few days after the injections, whether they choose Juvederm, or any other type of legal injection. This will disappear within a few days.

The Rewards
Having Juvederm Ultra XC injections, or any other recommended type of Derma Filla injections can be a very rewarding experience. These products are suitable for injection into almost any area of ​​the face where there are fine / deep lines or wrinkles, including the forehead, the creases around the eyes, the areas around the nose, and the corners of the mouth. Injections can help to temporarily smooth out these fine lines and wrinkles, and will leave your skin looking firmer and healthier. Injections also reduce the impact of further facial movement, which is one of the leading causes of frown lines and other lines that typically appear on the face as we age. Although the effects are temporary, they offer some of the longest lasting skin smoothing effects in the world of beauty, and injection treatments can be had more than once. As well as helping to smooth out deep lines and wrinkles, both Perlane and Juvederm are suitable for use as lip augmentation injections, which can help you to get fuller, more seductive looking lips, which are less susceptible to lipstick bleeding.

[ad_2]

Source by Afshin Nejad

[ad_1]

Voluntary Benefits Fill Holes in Your Benefits Program

We know now that voluntary employee benefits are becoming massively and increasingly popular and two reasons are that employees need them more and more and business budgets are getting squeezed by the economy.

Now we see that another trend driving businesses such as yours to increase the voluntary benefits offering is the immense usefulness of voluntary benefits in completing the benefits package. The frustrating problem here is that your benefits package has holes, gaps, and voids.

As long as the gaps exist, we can reasonably conclude that the benefits package was started, yet left unfinished and like a road left unfinished your people are driving along comfortably on the pavement you provided until they run into holes and are finding themselves falling into their shallow savings and deep confusion.

Would you agree this economy is at least somewhat interesting? Debt up. Bankruptcies up. Income down. Savings down. Check to check living up. Foreclosures up. Security down. Fear up.

Budget cuts and job losses demand and require affordable financial coverage for employees and this need is exactly what makes voluntary benefits so comforting, relaxing, and easy to get.

Black Holes and Financial Life Drain

As we are about to read, voluntary benefits are often designed to complete and fill the painful holes in your benefits package and here Dori Molloy, Regional VP of Transamerica Worksite Marketing says now, "… the best opportunity for voluntary benefits may be found in the gaps contained in current benefit offerings [which] … can complete a traditional benefits program … "and," A lot of the voluntary coverages, including accident and critical illness insurance … are affordable and for employees who do not have substantial savings the benefits provide a safety net for them.

You Are Not Safe, Are You?

The gaps in health insurance are financial pain – pain that most people are almost completely unprepared for especially in this uncertain economy – and with healthcare costs only going up this pain can be devastating, which makes it easy to understand why at least 6 in 10 of all bankruptcies filed in America are due to medical expenses. Plus, 8 in 10 of all people being forced into medical bankruptcy have health insurance, according to the now infamous Harvard Study.

We would not trust half a coat, half a pair of shoes, half a door, half a lock, half a security system, half a seat belt, or half a soldier to protect and serve us effectively, which causes a very natural realization of the fact that voluntary benefits, especially when it comes to healthcare are not only essential, they're just common sense.

So, with your voluntary employee benefits, you fill in the gaps, remove the dangerous holes, cover the leaks and do so in a way that satisfies your employees because they choose what they want and you do all of this for your business, for your employees – for free.

FREE Money! – Pretax Savings

This here is amazing.

We remember, obviously, that your employees are covering their voluntary benefits themselves, right? Well in addition to your voluntary benefits offering being free for you, your voluntary benefits offering is a pretax deduction.

What does this mean?

What this means is the sum total of your payroll is reduced by the amount of coverage your employees get, therefore the amount you must pay in matching FICA taxes drops because of your employees' coverage. Which makes this the bottom line – the more coverage, the more tax savings and the more tax savings, the more monthly cashflow.

More employee coverage is more cashflow.

More and more employee coverage is more and more cashflow.

And this is for free, hence, free money!

Voluntary Benefits – What I Am Getting, In A Nutshell

Once again, simply know, voluntary employee benefits are good for business growth, good for budgeting, good for employees – all for free, and actually put money in your pocket!

[ad_2]

Source by Jelani Asar

[ad_1]

Motorcycle enthusiasts will tell you, the thrill and adrenaline rush you get when riding a motor bike down the road is amazing. The exhilarating feeling will get you out of any low points in your life, as least momentarily. Whether you just have time to go for a quick run, or actually plan a road trip with your buddies, there's no comparison. Some people love the sound and feel of a powerful engine's vibration as they ride down the road. Driving a car just does not give the same thrill it seems. With this said, even though there is great risk involved in riding a motorcycle, can it actually improve your health and general well being? Read on to find out!

Some people will swear that motorcycle riding promotes healthy brain development. Furthermore, some people in their 50's and 60's credit their love for bike riding and other activities with their bike for helping them keep their brains functioning at a peak level. Riding a motorcycle pushes you to stay alert at all times and to multi-task. This helps people develop their cognitive skills at peak performance. For example, since motorcycle riders must watch out for many other dangers and to avoid potential hazards around them, they must process information quickly and respond accordingly.

In a research environment, motorcycle riders scored higher on the tests than the non-riding participants. Also it was shown that people who had their motorcycle licenses for longer periods of time, at least ten years, also performed the best in terms of cognitive ability. The health benefit of motorcycle riding does not end there though. It's no surprise that riding a bike takes a lot of effort and energy in comparison to driving a four passenger car. Controlling the bike takes almost every muscle in your body to balance, steer, and avoid obstacles in the road. Muscle tone and definition is something that frequent riders will tell you – motorcycle riding allows them to get their daily dose of exercise. You can even cut down on so many trips to the gym.

People value companionship these days, and sometimes you can not really do that in a four passenger car. Whether you ride a Harley or a Yamaha, almost all bikers will wave to each other when passing, and you can join many groups of people and organizations who get together to ride like a family. This creates a tight network of long lasting friendships, if you let it. Most other bikers are friendly and want to join you along the way if you are traveling in the same direction as they are. Companionship can raise your morale and mental wellbeing, which definitely plays a large part in your health.

Along that same note, riding improves your mood. Without a doubt, any motorcycle junkie and owner will tell you that they feel happier when riding. Happiness takes down our stress levels and prolongs our life span. It even helps us counter anxiety, depression, and general illnesses. If something lifts your mood, your health will definitely improve. So a joy ride with your bike could actually give you a healthier lifestyle.

To make way Reviews Another sure you are On safe at all times is to get a Comprehensive MotorCycle insurance plan . You'll have greater peace in mind when riding. Safety concerns may be slightly curbed knowing you have full insurance coverage.

[ad_2]

Source by Amanda Rodriguez

[ad_1]

Hedging is a process used by investors to protect themselves from any unfavorable events in the future. In general hedging is strategy that is incorporated to protect your investment in the stock market and increase the gains. For hedging, a person or an entity needs another entity to enter into the strategy; these other parties are known as counter parties. There are different ways to hedge an investment, however they all consist of agreements between you and the third party.

Difference between Insurance and Hedging

Insurance is a promise of compensation for specific potential future losses in exchange for a periodic payment. Insurance is designed to protect the financial well-being of an individual, company or other entity in the case of unexpected loss.

Hedging is a bit like insurance. The share buyer takes out the insurance of having a put option. It means he can not lose more than 20%. The speculator hopes to make profit from the fact the chance of share prices falling is very low.

Hedging can be implemented in a variety of ways including stocks, exchange-traded funds, and insurance, forward contracts, swaps, options, many types of over-the-counter and derivative products, and futures contracts.

Hedging and insurance are risk-reduction strategies. When you buy an insurance policy, you pay a premium to avoid risk while not limiting your potential rewards. Hedging, on the other hand, is a financial strategy that involves giving up potential financial gain to avoid financial risk.

Example of hedging:

Assume you are a farmer and you have a crop of corn that will be ready for harvest in two months. A buyer offers to pay you 5 bucks per bushel when your harvest is ready. If you agree to accept the offer, you lock in the price and you are guaranteed to earn at least 5 bucks per bushel regardless of what the market price is when your harvest is ready. In this case, you are hedged against a future price drop below 5 bucks. However, your hedge also limits your earnings to 5 bucks even if the price of corn is selling for more than this amount when your harvest is ready.

Example of Insurance:

Now assume instead of offering you 5 bucks per bushel of corn today, a buyer offers you a contract that gives you the right, but not the obligation, to sell your corn for 5 bucks a bushel when it is ready for harvest. For this right, the buyer charges you 200 bucks. In this case, you are insured against a future price drop below 5 bucks per bushel. However, if the market price for corn is higher than 5 bucks when your crop is ready for harvest, you can sell it for the higher price; thus, you insured yourself against downside risk without limiting your potential profits.

Up to 60 Save% on Private hedge insurance .

[ad_2]

Source by Tushar Chauhan

[ad_1]

Often confused with D & O and E & O insurance, EPLI (Employment Practices Liability Insurance) is a bit different in that coverage is for employers against claims made by employees who sue a business for violating their legal rights.

Employment Practices Liability Insurance can shield you from some of the extreme legal expenses involved in litigation. Obtaining an EPLI insurance policy can guard you against these common lawsuit claims.

• Wrongful dismissal – A wrongful dismissal occurs when an employer releases an employee from their duties in a wrongful and illegal manner according to that employee's rights. Wrongful dismissal examples range from age discrimination, sexual harassment, breach of contract, defamation of character, etc.

• Sexual harassment – Sexual harassment can fall under several different categories. One of those categories creates a situation wherein an employee feels if they balk against sexual innuendos in the form of unwelcome sexual advances whether verbal or physical, their jobs will be in trouble. They may be at risk of losing their job or not getting a raise or promotion. Another type of sexual harassment is one where the employee can not perform his or her tasks to full capacity or the environment surrounding the employer and employee becomes unstable.

• Defamation of character – Defamation of character may take place if an employer makes an untrue statement that is harmful to the employee. This can be as a verbal or written statement.

• Breach of Contract – More often than not, a breach of contract will occur under the spectrum of a union and one of its employees. There are requirements under which the guidelines must be met for the proper dismissal of an employee. If an employee disagrees with their dismissal and believes it to be against their union contract, they may then follow up with a grievance. If the grievance is not satisfactorily met on behalf of the employee, that employee may pursue costly legal actions against the employer.

• Failure to promote – Failure to promote can occur if an employee has justified and valid complaints wherein others are being promoted and they are not being promoted. The employee believes there is some other reason, other than work performance for this occurring on behalf of the employer.

• Race discrimination – Race discrimination can occur if an employee is fired due to their religious beliefs or ethnic background.

As you can clearly see being an employer today is akin to walking on a tight rope when it comes to the possibility of experiencing a lawsuit from one of your employees.

Obtaining EPLI for your company will defray the costs of a damaging lawsuit that may negatively affect your operation. You have worked hard to establish your company, why not protect it to the maximum. Purchasing an Employment Practices Liability Insurance policy is a smart business decision.

[ad_2]

Source by Peter W Green

[ad_1]

Each time that you get a paycheck there is a small amount taken out for your Social security benefits. These payroll deductions pay for your federal Medicare health insurance benefits. When you retire from the workforce at age 65, or earlier due to a disability, your Medicare coverage begins. It also covers your children under the age of eighteen if you die before retirement. You will receive Medicare even if you are a millionaire provided you paid in enough quarters. It does not depend on your assets or income. Bill Gates will get his coverage.

Medicare coverage is not complete and there can be co-pays. Most retirees buy supplemental insurance for some of the services that the basic Medicare benefits do not provide. Medicare covers hospital stays and limited skilled nursing facilities under "Part A." Doctors, outpatient care, and medical supplies are covered under "Part B." The two biggest gaps in Medicare coverage are long term care and prescription drugs. You can not double dip and if you collect coverage from another source, Medicare does have some reimbursement rights.

Some days I think that Congress named our two very different national health care programs "Medicare" and "Medicaid" just to confuse us.

Medicaid on the other hand is a welfare program that is not funded through Social Security. It comes from our general taxation with about half paid by each state and the balance paid for by Congress. Each state designs its own program. Medicaid covers many more services than Medicare and there are no co-pays. Medicaid covers hospitals, doctors, drugs, x-rays and long term nursing home care.

The key to be eligible for Medicaid is that you must be very poor. Your income and resources must be below a threshold set by the federal government and adjusted every year. You must also be able to prove that you are a US citizen. Aliens can not receive Medicaid benefits.

While Medicaid will cover long term nursing home care if your family member meets the Federal medical need guidelines, there are certain hooks. Medicaid can assert a payback lien against some future earnings, inheritances, gifts, lawsuit winnings and your estate. You will also be ineligible if you gave anything away during the five years before you apply. The period of time that you are ineligible is based on how much you gave away. Some transfers to spouses or disabled children are exempt from the penalty rules.

Surprisingly, Congress took some care not to impoverish a healthy spouse or disabled children who remain at home in the community. A home, a car and approximately $ 100,000 can be kept back for them when a disabled spouse goes to a nursing home. Congress also allows some limited asset protection planning and has sanctioned the use of "Special Needs Trusts" in a law called "OBRA 95."

The rules are all laid out in 95,000 pages of books cutely called the "POMS." You can . Read them You all at Http://www.ssa.gov . It does help to have a little working knowledge of your family's federal health benefits and the difference between Medicare and Medicaid. The rules cited in this article are very general and it is important to have exact guidance for each particular case.

[ad_2]

Source by Joseph M. Hoffmann, Esq

[ad_1]

HIPAA 5010 was adopted to replace the current version of the standard that covered entities must use when conducting electronic transactions. Version 4010 is currently being used under HIPAA standards.

Although HIPAA version 5010 gets much less attention than ICD-10 medical codes, it is just as important and physicians, medical practices and other health providers, should already be working with vendors on the version 5010 implementation.

Testing with external trading partners began in January of 2011. It is very important that you test as early as you can and often.

Here are some important 5010 compliance testing dates to be aware of:

• January 1, 2011 Level I compliance-ability to process 5010 transactions for testing and transition with able trading partners
• January 1, 2012 Level II compliance-all covered entities must begin using 5010 transactions

Simply put, transactions are electronics exchanges involving the transfer of health care information between two parties for specific purposes, such as a health care provider submitting medical claims to a health plan for payment. The Health Insurance Portability & Accountability Act of 1996 (HIPAA) named certain types of organizations as covered entities, including health plans, health care clearinghouses and certain health care providers. HIPAA adopted certain standard transactions for Electronic Data Interchange (EDI) for the transmission of health care data, as well. These transactions include, but not limited to:

• claims and encounter information
• payment and remittance advice
• claims status
• eligibility
• enrollment and disenrollment
• referrals and authorizations

Unlike the current 4010 transaction standard, version 5010 is more specific in the type of data it collects and transmits over the course of a transaction. 5010 also has clear situational rules built in which will help enhance the understanding of claim corrections, reversals, recoupment of payments and the processing of refunds.

For example, HIPAA 5010 will increase the diagnostic field size to accommodate the increased size of ICD-10 codes. Some other changes include:

• a version indicator that distinguishes between ICD-9 and ICD-10 codes
• format changes that will increase the number of diagnosis codes allowed on a claim

Interestingly, the 5010 format does not require the use of ICD-10 codes. However, it will be able to recognize and distinguish between the ICD-9 and ICD-10 medical code sets, which may help in a future with dilemmas of billing utilizing the dual code sets.

All health providers have to establish steps for preparing for 5010 Implementation and it might include the following:

• Software must be modified to produce and exchange the new formats (eg trading partners must be able to read incoming 277CA transactions).
• Review business processes to ensure changes are not necessary to capture additional data elements not previously required (eg Impact of patient registration, billing, and claim reconciliation).
• Contact your vendor and / or clearinghouse to ensure products and processes are updated (eg license includes regulation updates, and will the upgrade include acknowledgement transactions 277A & 999).
• Trading Partners should contact their local Medicare-Fee-For-Service contractor (MAC) for specific testing schedules.

[ad_2]

Source by Elena Newman