Controversial Medical Billing Practices by the medical profession

Controversial billing practice may account for $1 billion in medical fees paid by patients.
BusinessWeek (8/29, Terhune) reports, "As healthcare costs continue to soar, millions of confused consumers are paying medical bills they don't actually owe" due to a common, yet often illegal practice known as balance billing. When this happens, "an insurance plan covers less than what a doctor, hospital, or lab service wants to be paid," and the provider "demands the balance from the patient." BusinessWeek notes that "state and federal laws generally bar the medical providers from pressuring patients to pay the difference." Yet, as this practice continues, "economists and patient advocates estimate that consumers pay $1 billion or more a year for which they're not responsible." In fact, in California alone, an estimated "1.76 million policyholders...received such bills in the past two years, totaling $528 million," and 56 percent paid.

Typically, patients fall victim to balance billing when "medical providers participating in a managed-care network believe the plan's insurer is imposing too deep a discount on medical bills or is taking too long to pay." Currently, 47 states "ban in-network providers from billing insured patients beyond co-payments or co-insurance required by the plan," and "federal law prohibits providers from billing Medicare patients for unpaid balances." Yet, "regulators in most states have been slow to take action in billing disputes."

Industry experts say small business owners can make use of summer downtime.

The last few weeks of summer can be a useful time for small business owners whose companies are going through a slow period -- they have a chance to tackle some of those tasks they've been putting off. While some owners use summer downtime for big projects like writing an employee handbook, other owners cross off more mundane items from their to-do lists, such as entering that pile of receipts into their accounting software. Summer is a good time to get all this stuff done, in preparation for the fall. ... A mistake so many business people make is they wait until Sept. 1 to really gear up. They're really short-shrifting themselves. In planning downtime projects, owners may want to consider what changes...to make to their products or services, or how to adjust their marketing programs. Other experts recommend making changes to websites, examining costs and seeing what...can be cut, and thinking about employee issues.

Aging U.S. population visiting hospitals more, study shows.

There are reports that the "aging of the U.S. population is translating into many more visits to doctors' offices and hospitals, a reality that is taxing weak spots in the healthcare system, according to a government report released Wednesday." Investigators found that overall, "[p]eople made an average of four visits a year to doctors' offices, emergency rooms, and hospital outpatient departments in 2006, a total of 1.1 billion visits." The data also showed that the "number of medical visits increased 26 percent between 1996 and 2006, significantly higher than the 11 percent population growth during that period."

The national Centers for Disease Control and Prevention (CDC) in Atlanta released the statistics, and they came "from various components of [the] CDC's National Center for Health Statistics National Health Care Survey".

According to the CDC, "the observed increase in medical visits 'can be linked to both the aging of the population, as older persons have higher visit rates than younger persons in general, and an increase in utilization by older persons.'" In terms of racial disparities, the "overall visit rate was not significantly different for white and black persons." But, "African-Americans had higher visit rates than whites to hospital outpatient departments and emergency departments, and lower visit rates to office-based surgical and medical specialists." Additionally, "[r]egardless of setting -- physician office, outpatient clinic, or emergency department -- seven out of 10 patients left the medical visit with at least one prescription, and analgesics were the most common drug prescribed."

Medicare Supplements - Click for rates if you are 65+

At Home Employees doing Company work

Here's a question you may not have thought about: If one of your employee's is working at home and is injured, are you responsible? The answer depends on individual circumstances. For example, electrocution from a faulty cord on a computer you provided is different from a slip and fall on the way to the bathroom. As technology allows more and more work to be performed at home, it's a good idea to adopt safety expectations for your employees' home offices.
Here are some ideas to keep in mind if you have staff working from home:

* Temperature, noise, ventilation and lighting levels should be adequate.
* Electrical equipment should be free from hazards (e.g., frayed or exposed wires). Wiring and electrical cords should be secured and out of the way.
* The work area should be large enough to safely accommodate all equipment, wiring and so on without posing a risk of hazard to the employee.
* Hallways and doorways should be free from obstructions.
* The working environment should be free from clutter or materials that could create fire hazards.
* Floor surfaces should be clean and dry. Carpeting should be properly secured.
* There should be ample lighting for the work that the employee will be doing.
* The working area should be equipped with sufficient electrical outlets to accommodate all necessary equipment safely.
* Desks and chairs should be the appropriate size, height, etc., to provide comfort.
* Some organizations ask employees to sign a statement indicating that they will comply with the company's stated safety requirements; others even ask employees to bring in photos of their work areas indicating that they are in compliance with safety regulations.

Employee safety needs to be your concern even when their working from home.
If you or someone you know has staff that telecommutes or works from home contact your Business Insurance agent or we can offer references to you. For more HR updates ask us about our HR platform offered free to AMS clients. 800-334-7875

AMS Clients receive HR as a client benefit

Information which will help you to manage your business keeps you updated and ready. Sharpening Your Screening Interviews is a current article from our HR Affiliate.

Many employers adopt some sort of interview process. Unfortunately, many employers also abbreviate the process by hastily moving from the resume review stage right into the hiring interview stage. In between those two stages, however, the prudent employer will conduct screening interviews to separate the truly qualified job candidates from the unqualified candidates.There are four basic tips to help managers make the screening interview stage an integral part of a successful employee selection process:

Know Your Business Needs. Before placing that ad or starting the search, you hopefully already developed a job description that defines what your business needs are. The job description should be specific about the job duties, the necessary skills set, the type of required experience / education, and any other information to help you identity the ideal job candidate.

Review the Resume. Get familiar with the candidate’s resume before the phone or in-person screening interview. Make a checklist of standard questions to ask each candidate and any notes specific to the resume in question. Have all this information with you to briefly look over just before the interview to help confirm your mental map for the discussion.

Figure Out the Fit. During the screening interview, exercise sound judgment in assessing the candidate’s personality traits. Pay attention to the candidate’s overall attitude, behavior, and knowledge toward the company and any employees the candidate may have met already. For example, how well does the candidate respond during the interview?

Watch the Warnings. With the resume at hand, be sure to verify statements made on the resume, and isolate any apparently exaggerated or seemingly falsified information. For example, how the candidate phrased his or her familiarity of certain computer office programs on the resume may be questionable. In turn, ask the candidate to provide a concrete example.

By verifying the integrity of each candidate’s resume through the screening interview process, you will gain a clearer perspective of the how to better define your pool of truly qualified candidates towards selecting your next great employee.