insurance

How well does your professional bio showcase your abilities? Does it tell your personal brand story? Is it current and compelling?

Unfortunately, most insurance professional bios are stale and boring. They lack heart, depth and inspiration. Company profiles are often riddled with tired clichés and insurance industry jargon. And the typical executive bio is no better than a resume – a bulleted list of jobs and skills that can easily be forgotten.

A descriptive and well-written business bio puts a personal face on your offering and makes insurance prospects feel more comfortable and at ease. It clearly conveys your credibility and demonstrates your success, giving your prospects faith that you can really deliver on your promises.

Professional bios are multi-talented insurance marketing pieces. They can be incorporated into insurance websites, brochures and sales sheets. They can also be used for:

  • Insurance article bylines
  • Speaking engagements
  • Professional introductions
  • Networking
  • LinkedIn and other social networking profiles

Professional bios are highly recommended for insurance executives, insurance agents and anyone else who strives to develop and market a personal brand. In fact, some innovative, service-driven insurance companies display bios for all customer-facing employees on their websites.

BIO Dos

  • Use vivid examples of your capabilities.
  • Include objective measures of your successes.
  • Incorporate a few interesting quotes.
  • Keep the writing formal and in third person.
  • Customize your bio for each potential audience.

BIO Don’ts

  • Avoid long resume-style lists of job titles.
  • Don’t write in the first person.
  • Resist the urge to be verbose. Most bios can be completed in one to two pages.

Isn’t it time to tell your professional story in a way that’s relevant and interesting to your target market?

Do you need to get a UB04 form completed for an insurance company?  What is a UB04 form?  Where do you find one?  And how do you fill it out?  We run across these questions often in the world of medical billing.  Most medical health insurance claims are filed on CMS 1500 forms (sometimes called HCFA forms).  These are more common to most people.   Many billers don’t know when to use the CMS forms and when to use the UB 04 forms.

The UB04 claim form is used by facilities rather than physicians for their health insurance billing.  Hospitals, rehabilitation centers, ambulatory surgery centers, clinics, etc need to bill their services on the UB04 form in order to get paid.  Physician billing is done on the CMS 1500 claim forms. 

Every once in awhile we get a call from a person who is trying to get an insurance claim paid and they are told by the insurance company that they must file the claim on a UB04 claim form.  These people don’t have a clue what this form is or how to complete it.  They may have had to admit a loved one into a drug and alcohol rehab facility and now find that the facility doesn’t participate with their insurance plan.  These facilities often don’t file UB04 forms and can not help the family get reimbursed by the insurance company.

Many times the family has paid up front for the services of the facility and are now trying to get the insurance company to reimburse them.  The insurance policy may pay out of network but the claim must be filed correctly on a UB04 form.  Often times people are trying to collect many thousands of dollars on the claim.  Required fields on the UBO4 form include rev codes, value codes and type of bill.  What do you put in these fields?   These forms can be very confusing.  Where do you get the correct information to complete the forms?  And which fields are required on the form?  If the facility does not have a UB04 form to fill out, where do you get one? 

Unfortunately the answers are not easy.  The Rev codes represent the procedure codes.  The type of bill is a three digit number that represents the type of facility, the bill classification and the frequency of the bill.  The value codes are required fields only in certain situations.  It is very difficult to complete these forms correctly without previous experience or proper training.  Another catch is that the forms were changed in May 2007 to allow for use of the NPI number.  You must understand NPI numbers completely to determine where you should be entering an individual NPI number or a group NPI number.  And when you try to find UB04 forms for sale, you find they are available in boxes of 2500.

If you find yourself needing to file a claim on a UB04 form and don’t know what you are doing, make sure you look …

Real easy to start a business. Register your business name at the Companies Commission of Malaysia known as SSM and in about 45 minutes, you already have a business. However, a short business registration process is not meant in no time you too can benefit your business. You are lucky if this happens.

There are several other factors you should consider before stepping foot into the SSM.

  • Does your business simply want the money?

There is no doubt that every entrepreneur wants profits from the business. But, if you will continue to do business if you can not benefit in a long time as long as 3 or 4 months? What if that year is still not a profit? Knowledge, talents and money go hand in business. If you have any knowledge of the business, has been added to your chosen line of business is your hobby, for example, money has become a matter of no importance to you. But beware, do not bankrupt your interests are. Business talent can be polished. Which way is participating in workshops on managing the business conducted by business consultants who are more experienced.

  • Are your products and services to meet market needs?

You need to do a survey first before doing business. Spend more time making a survey of the community in which you want to open shop later. What is needed by the community. Are your products and services included in their will? If yes, state statistics so you can develop a good business plan will.

  • Do you have sufficient working capital?

Capital is important in determining the business can survive or not. A small business should be targeting at least have the working capital available capital up to 3 months even if not a profit. Failure to provide adequate capital stock will limit your future marketing efforts. Keep in mind that you are also responsible for promoting your business no matter how minor you use any media such as advertisements from home to home.

  • Are you willing to bear the risk in your business?

Every business has its own risks but the difference between us is the size of the risk. Small businesses remain at risk even if not by big business. But you need to know the level of risk you incur in the event something unfortunate like theft and fire. The transfer of risk can be made to subscribe an insurance policy and installing closed-circuit television or CCTV at the awards of your business.

  • Do you have assistance in case of any problem?

Assistance not only in terms of cost, but in every aspect of your business from the installation of front door through to the advertising business. Not necessarily you need money to have all forms of assistance. Sometimes after a long business, you will develop a network of individuals who are experts in their fields. Some will help you for free, or even with the cup of coffee. …

Most people don’t really understand the truth behind our banking system because it isn’t taught in our schools, not even to financial professionals. Oddly enough, the inconvenient history is omitted from all educational curriculums. I obtained a business degree in finance and there was one thing that never was taught to me about the origins of our banking system that I believe is key to the state of our banking system and our economy today. It is the fact that it was created under cover of legislation that was supposed to protect the economy and stabilize it. That is the primary mission of the Federal Reserve Bank. However, the real motivation was to shield the owners of the banks from competition and create a cartel.

I was also created to start a franchise that could print a fiat currency. A fiat currency is one that has no basis of value except by the good faith in the government to pay its debts. It means that if more money is needed in the economy, the bank simply creates it. This central bank could also then take control of all the reserves of all banks to protect the more wreck less banks from runs at the cost of the conservative ones, and get access to taxpayer money when the bank is in trouble. All the while, the Federal Reserve Act of 1913 was sold as a law that would protect the public. In terms of stabilizing the economy, the Federal Reserve Bank has failed miserably. In terms of reaching its true and hidden goals, it has been extremely successful.

People believe that the financial crisis is somewhat of a mystery. But every financial crisis we have had since the Federal Reserve Banking System has been in place has been related to debt. Under the current system, debt is used to create new money or to shrink the supply of money (by paying debt off) to attempt to control the economy, and allegedly stabilize it. In reality, since the loans were made with money created from nothing, the bank loses very little money. It is money that it never had in the first place. Technically, a retail bank with too many bad loans becomes insolvent, so the game is to roll bad loans over into larger ones and creates more money and gives the borrowers more money to continue to make the interest payments. There is also insurance that backs loans, so the government will pay for bad loans with taxpayer money. The Federal Reserve Bank has convinced the government that allowing big banks to fail would create great hardship in the economy, however, it is the massive creation of debt that fuels this system that causes the great hardship when the final cost of bailouts is passed to the public in the form of inflation due to an excess supply of money created by excessive lending to cover bad loans.

There is a rich history of how the banking bailout system has …

Importance of Using Proper Modifiers:

1. The physician performed multiple procedures

2. The procedure performed was bilateral

3. The E/M service was done on the same day of the procedure

4. The procedure was increased or decreased

5. The procedure has both professional and technical component

6. The procedure was performed by other provider (Anesthesiologist, Surgeon Physical Therapist, Speech Pathologists etc.)

7. Procedure on either one side of the body was performed

8. The E/M service was provided within the postoperative period

9. The E/M service resulted to Decision of Surgery

10. Unusual Circumstance

Maximize your reimbursement for bilateral procedures by using the correct modifier.

Bilateral Modifier (-50)

Depending upon the insurance payer, processing claims with bilateral procedure should be paid 150%

Medicare Part B requires one single line of bilateral procedure code with Modifier 50. They normally process the claim with 150% reimbursement. But again, you have to check on this in your state and in your region.

Some commercial insurance would prefer Two Lines of the same code, once with 50, second without 50. Then second modifier on the 1st line is RT or LT, modifier RT or LT on second line, with 1 unit of service each code. Must be reimbursed at 150%

Some commercial insurance would prefer two lines of the same code with modifier LT or RT on each line with 1 unit of service each code. Must be reimbursed at 150%

Always check on your Physician’s Fee Schedule if the procedure code is billable as bilateral J.

Using LT & RT modifier is used to specify which side of the body the procedure was done by the physician. Medicare Part B based on my experience requires specific modifier, either LT or RT. Example you may report procedure 64626 done on the Right C4-C7 Facet Joint Nerve Ablation as 64626-RT.

Modifier -26. Professional Component.

Example: Report procedure code 77003 – Fluoroscopic guidance and localization of needle or catheter tip for spine or paraspinous diagnostic or therapeutic injection procedures (epidural, transforaminal epidural, subarachnoid,, paravertebral facet joint, paravertebral facet joint nerve or sacroiliac joint) including neurolytic agent destruction) with modifier -26 to indicate the physicians Professional Component only reimbursement and not technical component. If the provider’s office owns the fluoroscopic equipment, do not append -26 modifier.

Modifier -25. Significant, Separately Identifiable Evaluation and Management Service by the Same Physician on the Same Day of the Procedure or Other Service.

Example: Report E/M code 99213 (Office or other outpatient visit for the evaluation and management of an established patient) with Modifier -25 for procedure code 20610 Knee Joint Injection done on the same day of the procedure. Modifier -25 indicates significance and separate identifiable E/M service outside the procedure done on the patient. DO NOT use modifier -25 to report E/M service that resulted for initial decision for surgery.

Instead use modifier -57 for Decision for Surgery

Modifier -24. Unrelated Evaluation and Management Service by the Same Physician During Postoperative Period

Example: Report E/M code 99213 with Modifier …

It is exactly 100 years since the pride of the White Star Line, the RMS Titanic, hit an iceberg in the Atlantic Ocean and sank with the loss of over 1500 lives.

The centenary has prompted many insurance companies on both sides of the Atlantic to publish documents relating to the greatest maritime loss to date in relative costs, mostly showing their company's involvement with claims payouts.

When the Titanic sank on the 15th of April 1912, the Lutine Bell was run at Lloyd's of London, and a very rapid claims process was begun.

A few months earlier the ships owners, the White Star Line, had instructed insurance brokers Willis Faber and Co. To find cover for the hull, cargo, contents and personal effects of the ship. Willis Faber passed the 'slip' to their Lloyd's mercantile division where it was assessed and subsequently underwritten by multiple syndicates and insurance underwriters acting on behalf of members.

The Titanic's hull was insured for total loss for $ 5 million or just over one million pounds sterling at the exchange rate of the time. The policy also included total loss cover for cargo at $ 600,000 and contents at $ 400,000 a value equivalent to two hundred thousand pounds.

The original breaking slip passed around Lloyd's has been lost, but was photographed and can be seen in Wright and Fails book of 1928 called 'A history of Lloyd's'. It shows that seven large insurance companies took nearly forty percent of the risk between them and the other sixty percent was underwritten by over seventy individuals and Lloyd's 'Names'.

According to documents recently released by Willis the marine insurance policy cost White Star £ 7500 or $ 38,000 to insure the Titanic at a rate of 15 shillings per hundred. Modern day rates for cruise liners are significantly lower.

The Ship was significantly underinsured for a value of only five-eighths of its replacement cost. This was apparently because the owners thought the hull to be unsinkable and were prepared to bear the additional $ 3 million dollars of risk themselves.

Willis state that despite the owners belief in the vessel being unsinkable, they had trouble placing all the hull cover at Lloyd's and some forty thousand pounds was underwritten in Germany. There was also an extremely high excess or deductible of 15% of the insured value.

Four days after the Titanic sank the US senate held a preliminary investigation at the Waldorf Hotel in New York. The surviving officers of the ship presented their evidence to the panel describing the events of the sinking and signed what is called a 'protest' which enable insurance claims to be paid.

Incredibly White Star were reimbursed for the loss of the hull within seven days of the sinking, usually minus the excess, and fully paid up on cargo and contents losses within thirty days.

They were however grossly underinsured for their liability to others given the value of the people on board. Claims against the company exceeded …

As the name implies, a Credit Balance happens when excess money is collected compared to the Charges for a service rendered by the Provider. This could be due to many reasons and has to be fixed while the final steps of medical claims processing are done. The Credit Balance could be due to an excess patient payment in the form of Co-insurance or Deductible; Or it could have due to over-payments from the Insurance Payers. Let us analyze some scenarios and why it is important to be handled promptly:

Patient Credit Balance:

Patients may have paid an amount up front based on the assumption of what their Payers would cover. Once the medical claims processing is completed and the Payer pays in full, then the Patient's payment is in excess. The physician billing solution can also call the patient and give the option of adjusting this excess against future visits or sending a check. But in either scenario, the Patient's consent has to be obtained and is mandatory.

Payer Credit Balance:

Many times the Credit Balance happens because of Over-payments by the Payers. Even the Patient's Credit Balance is usually due to the Payer paid more than anticipated. In medical claims processing, it is very important to handle the payments from Payers on priority. This not only projects the correct Cash flow as a result of the physician billing solution, but also advances inflated AR. Some scenarios on Payer Credit Balances:

1) Both Primary and Secondary Payer pay as Primary
2) Payer pays more than Allowed amount by error
3) Cross-over errors, especially between Medicare and Medicaid
4) Privately purchased Plans – always pay as Primary, although there could be another Primary

Rules:

In all these instances, there are very strict guidelines and time frames within which the excess money has to be returned either to the Payer or to the Patient, as the case may be. In case of Payer errors, the Payer has to be informed of the error within 30-120 days depending on the Payer. Failure to notify within the timeframe could have been viewed as 'Fraud' by the Payer and the State with stiff penalies. If the Payers refuse the refund (as in the case of privately purchased plans), then that money belongs to the Patient and the Patient has to be notified. The medical claims processing and physician billing solution providers have to keep these requirements in mind and process the Credit Balances on a daily / weekly basis to avoid any trouble for the Provider and the Practice.

Recoupments and Offsets:

Some payers would adjust the payments for current and future claims against Credit Balances owed to other Payers which are Recoupments. When the Payers adjust the payments for current and future claims against the over-payments made in the past in their own Plans, these are called Offsets.

The best option to handle the Credit Balances is to outsource medical billing to a professional medical claims processing company.

Log on to http://www.mgsionline.com/medical-claims-billing.html to know …

In financial management studies, an effective financial goal should have 5 characteristics which could be easily remembered as S-M-A-R-T. The following paragraphs explain all the 5 characteristics:

1) Specific

We might be thinking of being financially free but do you know what it takes? This goal is seems to be too general. Our goal needs to be specific so that we can focus particularly in each area of financial planning and easily to manage our own expectations. Specific goal normally has only one outcome.

For example, goal to invest RM200 per month in unit trust and accumulate at least RM2400 in a year; or spend within our budget every month. These specific goals are going to have different outcomes but when combined, they will ensure our cash flow to be healthy. When each specific goal is accomplished, we are getting nearer to financial freedom.

2) Measurable

We might be working very hard, but how do we know whether our goal is achieved? Therefore, our financial goals should be quantifiable.

For instances, we want to invest and accumulate RM50,000 in 2 years and the progress can be easily quantified by looking at our investment account statement.

In fact, we must be able to measure or review the progress of achieving the goal such as calculating our current net worth, debt-to-income ratio and reviewing, return-on-investment (ROI) and our current insurance policy. It is good if we can keep a journal and review our current planning.

3) Achievable

Many people are influenced by the ‘Law of Attraction’ and believe that ‘nothing is impossible’. Because of this, we’re tend to set difficult goals which require great effort. However, are these goals realistic and achievable? It’s important to know whether the goal is within our potential and logical norm.

For example, if your target is to achieve RM1 million in a year by only investing RM1000 per month in any scheme. How likely can these be achieved? In fact, such investment scheme will require very high ROI within a short duration and often comes with very high risk. You might lost your capital easily.

The most importantly, we should not stretch ourselves to achieve unrealistic goals. This is to avoid frustration over failure which could ended up in great disappointment.

4) Rewarding

We want to achieve a goal because want to get something in return or else nobody will work hard. While working towards goal achievement, we must be certain on the outcome to be achieved and it’s importance to our life. In fact, it must be meaningful and enjoyable.

For example, a man wants to invest his money to accumulate education fund for his son in 20 years. In the future, this goal will be rewarding because his son will be able to enroll into higher education.

However, the rewards could be in any form such as material, financial, relationship and spiritual.

5) Time-bounded

We need adequate time to achieve our goals. It could be short-term, medium-term or long-term, depending on the type of …

Trade overseas needs the support of export documents. Operations with foreign countries are made very complex, the sellers must explain what they are selling and the buyers must know what they are buying. For that reason, we use the following export documents:

Some of export documents are used for commercial purposes like bills, notes and weight packing. There are also documents to guarantee the quality of what is being exported. Insurance documents certify what is covered by insurance. Bills of lading are examples of transport documents.

There are different export documents that do not offer the same benefits to each user.

Letters of credit are an instrument that guarantees to the seller that he or she will be paid for the merchandise sent when it matches the criteria set in the contract by the importer.

Most are irrevocable and confirmed, which means that they can not be modified but with the consent of the parts involved. Additionally, these documents treat the exporter from any worry about nonpayment.

The export documents can be revocable or irrevocable, confirmed or notified.

Revocable documents give the holder the ability of modifying them without the consent of the other parts. Banks may also reserve the right to give or refuse payment.

Irrevocable: the bank can not reverse its commitment, whatever the changing circumstances of its client, without the agreement of all parties concerned.

Notified documents give protection to the exporter but only to a certain degree. They will not cover for natural, political or transfer-related problems.

Confirmed, where the commitment of the banker of the importer is supported by a banker in the country of the exporter. The exporter must fully respect its obligations and it is guaranteed to be paid.

Exporters run a series of risks when venturing into new lands. First of all, they risk not being paid by the importer in the foreign country. Secondly, if they do not know the political and economic situation of the country they are exporting to, they risk losing their money. Another risk they take is related to the exchange rates. Export documents exist to relate these risks. …

You have heard it asked many times before. Maybe you have even asked it yourself, but what does bonded and insured really mean? Why do you need to ask vendors about this? Is this really important?

First, I will explain what each means. Then, I will go into detail about what is important with these terms.

There are only three types of bonds available. The first is a bail bond. This only applies to people who are trying to get out of jail, therefore it is not applicable to hiring a vendor. The second is an employee dishonesty bond, or a surety bond as they are also called. The third is a performance bond. These are frequently used by contractors to guarantee their services.

I will skip discussing the bail bond.

An employee dishonesty bond, or a surety bond is issued by an underwriter to guard against theft. These are issued in various amounts. The most common is $5,000. I will use an example of how this would work. Let’s say you hire a contractor to work on your home. In the process of their working on your home, you notice that some of your jewelry is missing. You contact the police and the bonding company. After an investigation, it is determined that the contractor took your jewelry.

The bonding company will then notify you that they will award the price of the jewelry, or the maximum amount covered by the bond. The bonding company will wait for a conviction of the person who took your jewelry. If the adjuster determines that the value of your jewelry is $6,000 and the surety bond is for $5,000, they will award you $5,000 because that is the maximum covered by the bond. There are conditions to this. The bonding company will only award the amount if the item is not recovered. And, the bonding company will only award after a court conviction takes place.

A performance bond is taken out to guarantee service or work. Again, another example. Let’s say you hire a contractor to build your dream home. The price to build your home is $250,000. A surety bond for the project could be issued to you at the cost of the contractor. This would cover you if the contractor tries to leave before the project is complete. Or if the contractor does not fulfill obligations agreed to in the contract. If you go through a bank to get your home built, they will most likely require the bond be issued to them, since they will be a greatest exposure to loss. Performance bonds can be taken out on a variety of things, but are most frequently used in the construction or contracting business.

Speaking as an owner of a janitorial company, there are things more important than a bond. There are many companies that cover theft internally. In other words, they have a policy about theft and cover the losses themselves due to the size of their companies. If theft …