Feng Shui Animal Symbolism

The role of both real and mythological animals is referred to frequently in feng shui theory and folklore. In many books, there is a description of an ideal house, which has a turtle behind it, a phoenix bird in front of it, and a dragon and tiger on either side. These four animals are symbolic of land and building formations. For example, to have a turtle behind the house for support or protection is a metaphor for a larger structure or a literal mountain. To have a bird in the front is symbolic for a much smaller land formation.

There is a concept that "chi" (air currents) move around a property and the higher land form in back (the turtle) protects the house, while a smaller land form in front (bird) helps the house receive the proper amount of chi . Like the edge of a bowl, the phoenix in front helps shore up or contain energy near the entrance of the house.

Then, the tiger and dragon on each side of the house represent neighboring houses, buildings, or real hills. These forms act as a way of protecting the house. In a general sense, a house that is not surrounded by other structures or land formations is a bit vulnerable and overly exposed to the elements. Some people take these references to the animals literally and they will place figurines of these creatures around their home for good luck and protection. At least one feng shui master I have studied with has alluded to the possibility that these animals also represent the shapes of certain important constellations.

Another popular feng shui creature is the fish. Fish symbolize long life in Chinese culture, so paintings and sculptures of them are seen as lucky. In the actual application of feng shui, fish in tanks and ponds are just an excuse to help circulate water. It is the water, which is the real remedy. But because feng shui comes from a very superstitious culture, the number of fish and the color of the fish in the aquarium have taken on exaggerated significance. As well, different types of birds are supposed to be omens for the occupants if the bird is seen flying by or creating a nest on the roof.

The image of a horse can not help but to symbolize travel and movement. One folk remedy is to place a Horse figurine facing the door for occupants who want to sell their home.

Lions and tigers are considered powerful, ferocious animals. Representations of them in pictures or sculptures should be done with caution, according to people who adhere to these animal cures. You may have seen stone lions flanking the entrance or stairs of a large building, but they would be considered inappropriate for a residence.

One of the Zodiac signs in Chinese astrology is a Tiger. Women who are the sign of the Tiger are considered fiercely independent and have a more difficult time settling down with a man. February is the month of the Tiger and according to auto insurance statistics, more car accidents occur in the month of February. This would be consistent with the Chinese interpretation that the fast-moving Tiger is also accident-prone.

It is interesting to note some of the cultural differences in how we relate to animals. For instance, in Chinese astrology a person born in the Year of the Rat can be a very intelligent person and a Snake person can easily be interested in metaphysics and spirituality. In the West, we think of the rat and snake as being sneaky and conniving. In some religions there is a belief that all human beings have lived at least one incarnation as every type of animal, and therefore we have an unconscious understanding of what these animals are capable of in their personalities and strengths.

Some birds are more monogamous than people, so there is a notion that putting up pictures of lovebirds in the bedroom will attract true love. These kinds of things can work as placebos, but are not considered the most sophisticated feng shui remedies.

Elephants have a reputation in both Chinese and Indian culture for attracting wealth. Images of trunk-up elephants often adorn the homes of people hoping the elephant will be a lucky image for them.

There are many more animals that have meaning in Chinese culture and / or specific to feng shui. Supposedly, a metal Rooster placed in the proper location can stop someone from committing an adulterous affair. Taken out of context, these animal symbols can seem strange, but they are really not much stranger than the meanings we attach to some inanimate objects in the Western world. Be it a country's flag, a car hood ornament, a designer label, or a religious sign, we place importance on many symbols that go unnoticed or unrecognized by other cultures.

Many people are surprised to find out that I do not prescribe any of these animal symbols as feng shui remedies. While I understand the psychological relief that they may provide, I do not feel that these symbols can change the energetic composition of a room. And with symbols ultimately being very personal, (like our dreams), I do not see how they would work for everyone in the same manner.

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SuperGlass Windshield Repair Franchise Review

SuperGlass Windshield Repair Company was founded in 1992 in Orlando Florida in the United States. It started offering franchises in 1993. It provides glass repair services. In 2010, it was ranked 161 by Franchise 500. The company is saving its customers money through its repairing services and avoiding replacements.

It has more than 200 franchises. Its expansion plan includes countries like Australia, Western Europe, Mexico, and New Zealand. The main goal is customer satisfaction. The customer base of SuperGlass includes commercial fleets, insurance companies, auto dealerships, individual automobile owners, and rent a car companies. The pricing range for the repair services is from $ 20 to $ 100 depending on the type and volume of work.

Benefits: The company has a range of customer database for windshield glass repairs. Through their services SuperGlass is saving plenty of dollars on replacement of glass windshields. The SUperGlass Windshield repair franchise can earn you good profits and also offers you flexible work time. You can work full time, part time, evening and weekends for this business. Besides that, SuperGlass Windshield Repair franchise has numerous benefits like –

· SuperGlass is a leader in technology, customer services and training. Its windshield crack repair program is for total customer satisfaction and overcomes budget and logistical difficulties.

· A franchise of SuperGlass gets two week training program and certification to repair glass and cracked windshield. It provides complete technical training and customer services in the field as well as classroom.

· It has maintained its professional image and offers uniform to all its technicians on job as a part of its customer service program.

· The franchise of SuperGlass is an independent and local business. The prime goal is to exceed customer expectations and SuperGlass offers all training and support to attain this goal.

· SuperGlass always try to innovate new technologies. Its glass crack repair and manufacturing departments constantly test and develop new resins and technology that helps them to remain the quality leaders in the windshield crack repair industry. It also provides marketing support to the franchises.

Investment: The SuperGlass franchise fee is $ 9,500 to $ 28,500. The total investment is $ 12,000 to $ 31,000. The royalty fee is 4%. The agreement is for ten years and is renewable. SuperGlass takes $ 1000 as renewable fee.

All in all, SuperGlass Windshield Repair is a leading company in this industry. Its research and studies enhance its technologies and methods to make it top servicing company. The main goal of SuperGlass is customer satisfaction. Through its quality services, it is achieving that goal and saving their lots of money on replacements. Owning a franchise gives you an opportunity to develop your own independent business with complete training and technical support from SuperGlass.

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Is US Medicare Coverage in the Philippines Possible?

Between 2007 and 2008, rumors and reports came out that US Medicare coverage in the Philippines is possible. Generally, US Medicare coverage is limited to all 50 states. Has Medicare gone portable at last? This article explores the truth behind the talks.

A Look Back

Sources estimate that out of the 4 million legally staying Filipinos in America in 2008, approximately 80 percent hold US citizenship and a number are covered by Medicare.

Medicare is America's federal health insurance program. It was first created in 1965 to benefit citizens aged 65 and older. In 1972, the program was revised, allowing younger people with Lou Gehrig's disease, permanent disabilities and end-stage renal health complications to enroll.

Understanding the Structure

Medicare is a collective term that may include a number of plans:

  • original Medicare that provides hospital insurance and medical insurance
  • Medicare Advantage that provides both basic and extra healthcare services, as offered by private health maintenance organizations (HMOs) and
  • prescription drug plans that may or may not be tied to a Medicare Advantage plan

Additionally, there are Medigap plans to supplement what original Medicare does not cover. They are offered by private insurance companies.

The current policies are lettered C to J. However, in a fact sheet released by the Department of Health and Human Services of the US, new Medigap plans M and N will replace plans H, I, E and J starting June 1 of this year .

Off-Shore Medicare Coverage in Theory

Under the original plan, the circumstances that allow Medicare portability are limited. Coverage outside America is permitted whenever a foreign hospital is nearer than any other hospital on American soil. In rare emergency cases, those traveling "without unreasonable delay" through Canada may also avail of off-shore coverage – provided again that the Canadian hospital is much closer than an American hospital.

In March 2010, the Department of Foreign Affairs of the Philippines confirmed that under the original Medicare plan:

"… Residents of Guam and Saipan … are allowed to seek medical treatment … on emergency cases, availing of their Medicare benefits in Philippine medical facilities, due to the proximity of the Philippines vis-a-vis Hawaii, the nearest US state. "

This development is credited to the efforts of Madeleine Bordallo, congresswoman of Guam, and of Roberto Romulo, former Department of Foreign Affairs secretary, who lobbied that Philippine hospitals be allowed to issue Medicare reimbursements.

Off-Shore Medicare Coverage in Practice

My Philippine Retirement made a round of phone calls to check whether hospitals in the Philippines have already reimbursed Medicare benefits under the original plan. There were no recorded cases yet, the staff said. In fact, majority of the hospitals appeared to be unaware of "US Medicare."

They did supply the following list of honored international health insurance plans, some of which have tie-ups with Medicare Advantage plans:

LIST A. International Health Insurances Honored in Selected Luzon-Based Philippine Hospitals as of March 2010

  • (Allianz) Worldwide Care – Asian Hospital
  • AETNA – Asian Hospital
  • AETNA Global Benefit – Makati Medical Center
  • Alliance – Asian Hospital
  • Blue Cross International – Asian Hospital
  • Blue Shield – Asian Hospital
  • Calvo's – St. Luke's Hospital
  • CIGNA – Asian Hospital
  • GMC Services – Makati Medical Center
  • HTH World Wide – Makati Medical Center
  • IMA – Makati Medical Center
  • IMG – Asian Hospital
  • International Health Insurance of Denmark – Makati Medical Center
  • International SOS – Makati Medical Center
  • Net Care – Asian Hospital, Makati Medical Center
  • Pacific International – Asian Hospital
  • Prestige International – Makati Medical Center
  • StayWell – St. Luke's Hospital
  • TakeCare – Asian Hospital
  • TieCare – Asian Hospital, Makati Medical Center
  • Vanbreda International – Asian Hospital, Makati Medical Center
  • William Russel – Asian Hospital

Availment of insurance benefits varies by health maintenance organization (HMO), insurance plan and servicing hospital. The insured must inquire about their Medicare Advantage benefits by HMO or plan name. Specific concerns may be sent to the respective customer care and credit / billing departments of the hospital.

LIST B. Contact Information of Selected Philippine- Based Hospitals that Honor International Health Insurances with Possible Medicare Advantage Tie-Ups

Impact on Philippine Retirement Decisions

The affordability of healthcare services in the Philippines is somewhat let down by the "pay-as-you-go" system, but a recent turn of events are changing the way potential retirees view the minor "cash first" inconvenience.

One such development is the direction that Medicare portability is headed. Statistical trends indicate that by 2011, Medicare expenditures will soon exceed the revenues generated from the trust fund. This can be prevented when cheaper off-shore facilities are used to deliver the same-quality healthcare services offered in the US, experts explain.

Another development is the health reform bill on patient protection and affordable care that US President Barack Obama signed in March 2010. The current reform permits off-shore coverage and insurance of people with pre-existing health conditions. There will also be a minimum annual tax penalty of $ 695 for those who are unable to secure health insurance – now no longer just an option but a requirement.

Many US tax payers are anxious that the latest health reform will come with a steeper price tag. "I'm anticipating my insurance premium (monthly payments) to increase from $ 100 … to more than $ 500," fears Terry who works for the federal government and hopes to retire in 2020.

Lesser take-home pay (and savings) combined with the fact that US Medicare coverage in the Philippines is possible (mostly through Medicare Advantage plans) is prompting former Filipinos like Terry to reconsider the Philippines as a good place to get cheap but decent healthcare – yet the "best bang" for dollar earnings. *

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5 Hidden Costs of Motorcycle Ownership

A lot of the time when people buy things like cars and motorcycles, they only look at the actual sticker price of the vehicle. While this is obviously a major part of determining your ability to afford something or not; It is not the whole story. Cost of ownership is a large part of owning any motor vehicle that is often forgotten about until it is too late. To help you understand what it could really cost to own a motorcycle, here are the 5 hidden costs of motorcycle ownership.

Motorcycle Insurance
Motorcycle insurance is the largest hidden cost to owning a motorcycle. As safe and good a motorcycle rider as you may think you are, accidents are bound to happen and are often times not even your fault. When talking about how common motorcycle accidents are, many people say that its not "if" you are going to crash, it's "when." Insurance companies understand this so personal liability insurance for an motorcycle rider is often extremely high. Motorcycle insurance is also expensive for the bike itself do to that same probability accident probability.

Motorcycle registration
Other then purchasing the motorcycle and paying for the insurance, many people forget that you have to pay for registration. Just like with the insurance, this a pricing cost that will have to be made annually. While the price of the registration wont break the bank in and of itself, when stacked onto all the other hidden costs, it can really be a burden.

Motorcycle Maintenance
The next thing on the list after motorcycle insurance and registration is maintenance. Following the dealer recommended regular maintenance is important if you want to keep your motorcycle in top running shape for a long time. While this may be expensive, it will be cheaper than having to buy an absolutely new motorcycle if yours breaks due to not following proper maintenance.

Motorcycle Modification
While not an essential part of motorcycle ownership, the modification of ones bike often comes shortly after purchase. Everyone likes to customize their motorcycle in order to make it their own and we cant blame you. Those aftermarket parts are not cheap though. Some people even spend more money on parts then they did the whole motorcycle to start with!

Motorcycle Financing Interest Payments
Most people who buy a motorcycle cant afford to pay for the entire thing up front. This means that they have to finance the motorcycle with either a bank or the dealership they bought it from. The ability to do this comes with our last hidden cost known as interest. Sometimes people ending up owed more to the bank then the motorcycle is actually worth! This is never a position you want to be in.

Above you will find 5 hidden costs of motorcycle ownership. Unfortunately, these are not the only hidden costs you will encounter when owning a motorcycle however. When purchasing a bike, be sure to do all your research and make sure if owning a motorcycle is really something you can afford in the long run!

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Automobile Dealerships – Valuing Blue Sky

Blue Sky is the intrinsic value of an automobile dealership, over and above the value of its tangible assets. It is sometimes equated to the goodwill of a car dealership.

Most articles regarding the blue sky value of new car dealerships cite a multiple of earnings formula, such as three times earnings, four times earnings, and so forth. The idea that "blue-sky" can be determined by anything times anything is just plain wrong.

Even NADA the National Automobile Dealers Association in its publication entitled "A Dealer Guide to Valuing an Automobile Dealership, NADA June 1995, Revised July 2000 bemuses, in part, with respect to valuing a dealership by using a multiple of earnings: A Rule of Thumb valuation is more properly referred to as a "greater fool theory." "It is not valuation theory, however."

In its Update 2004, NADA omitted its reference to "fool", but referred to the multiple formula as rarely based upon sound economic or valuation theory, and went on to state: "If you are a seller and the rule of thumb produces a high value, then this is not a matter of great concern. Go for it, and maybe someone will be stupid enough to pay you a very high value. "

A dealership's blue sky is based upon what a buyer thinks it can produce in net profit. If potential buyers think it can not produce a profit, the store will not sell. If it can produce a profit, then variables such as desirability of location, the balance the brand will bring to other existing franchises owned, whether or not the factory will require facility upgrades, and so on and so forth, determine whether or not a buyer will buy that particular brand, in that particular location, at that particular time.

I have been consulting with dealers for nearly four decades and have participated in over 1,000 automotive transactions ranging from $ 100,000 to over $ 100,000,000 and have never seen the price of a dealership sale determined by any multiple of earnings unless and until all of the above factors have been considered and the buyer then decided he, she or it was willing to spend "x" times what the buyer thought the dealership would earn, in order to purchase the business opportunity.

To think otherwise would be to subscribe to the theories that (1) even though you think a dealership could make a million dollars, the store is worth zero blue sky because it made no money last year; and (2) if a store has been making $ 5 million per year you should pay say 3 times $ 5 million as blue sky even though you think you will not produce that kind of profit. Both propositions are absurd. If a buyer does not think a dealership is worth blue sky, then what he is really saying is that he sees no business opportunity in the purchase and therefore, in my opinion, he should not buy the store.

Each dealership is unique with respect to its potential, location, balance that its brand brings a dealer group, and condition of facility. The sale is also unique with respect to whether it is a forced liquidation, orderly liquidation, arms length, insider, or a case where an anxious buyer is trying to induce an unwilling seller. There are management factors to consider, length and term of leases, possibilities or non-possibilities of purchasing the facilities and whether or not the factory wants to relocate the store or to open a new store up the street.

In the car business it is impossible to pick a dealership or a franchise out of a hat, multiply its earnings by some mystical number and predict either what the dealership is worth, or what price it would sell for – and it does not matter if you are talking about a Toyota, Honda, Ford, Chevrolet, Chrysler, Dodge, or any other dealership. At any given time one franchise might be considered more or less desirable than another, but they are all valued in the same manner.

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Insurance Required During Construction Or Conversion of Vessels Or Rigs

1. Builder's All Risk Insurance:

Usually during the contract negotiation stage, when it is as yet unclear as to which party will be accepting which liabilities, which party will be responsible for procuring the insurance and absorbing the deductibles, etc., both parties look more deeply into the breadth of available BAR coverage.

We can say that Builder's Risk Insurance for the energy class of business provides coverage under three different forms:

  1. London Institute Builder's Risk Clauses 1.6.88 (CL 351) – or American equivalent
  2. WELCAR form
  3. Custom forms tailor-made to specific risks or Owners or shipyards.

Is the protection provided under all BAR policies the same? No! For a comparison between wordings please contact a trusted insurance broker of your choice.

2. War Risks and Strikes, Riots, Civil Commotions (SRCC):

a. Institute War Clauses Builder's Risks 1/6/88 ( CL 349) –

Coverage incepts once the vessel is launched (or wet) and provides coverage for loss of or damage to the insured vessel / rig caused by:

  • war, civil war, revolution, rebellion insurrection, or civil strife arising therefrom, or any hostile act by or against a belligerent power
  • capture seizure arrest restraint or detainment, arising from perils covered above, and the consequences thereof or any attempt thereat
  • derelict mines torpedoes bombs or other derelict weapons of war.

b. Institute Strikes Clauses Builders' Risks 1/6/88 ( CL 350) –

Provides coverage for loss of or damage to the insured vessel / rig caused by:

  • strikers, locked-out workmen, or persons taking part in labor disturbances, riots or civil commotions
  • any terrorist or any person acting maliciously or from a political motive.

We recommend that this coverage be amended to include Vandalism and Malicious Mischief.

Please also review if the terrorism coverage provided under this clause is either restricted or broadened, or if there are any other applicable clauses such as Sabotage & Terrorism Endorsements. In any case, be sure that the coverage afforded is adequate for your Client so your Client makes an informed decision.

3. Liability – Insurance coverage that protects an insured against claims made by third parties for damage or injury to their property or person. These losses usually come about as a result of negligence of the insured. In marine construction, this policy is referred to an MGL, marine general liability policy. In non-marine circumstances, the policy is referred to as a CGL, commercial general liability policy. The construction contract should determine which parties are liable in which instances for losses of Third Party Liability nature.

Insurance policies can be divided into three broad categories:

  1. Product Liability – Protection against a Manufacturer's liability for injuries or property damage after a manufactured product has been sold. Extraordinary liability accompanies the manufacture of a product.
  2. Completed Operations – Protection against a Contractor's liability for injuries or property damage suffered by Third Parties as a result of the Contractor completing an operation.
  3. "Trips & falls & damage" – Protection against injuries or property damage on premises or hulls within care, custody, control of a party.

4. Umbrella Liability – This type of liability insurance provides excess liability protection. Your business needs this coverage for the following reasons:

  • It provides excess coverage over all the "underlying" liability insurance carried.
  • Instead of purchasing a large limit on all of an insured's policies, this structure allows an insured to purchase the coverage once to sit atop various policies, thereby increasing the limit for many policies.
  • We recommend that this coverage provide automatic replacement coverage for underlying policies that have been reduced or exhausted by loss.

5. Additional coverages available for consideration during the construction phase:

  1. Cargo / Transit Insurance – to protect against All Risks of loss of or damage to the shipments of material, equipment, etc. that will form part of the construction (ie, the topsides from Russia to the UK)
  2. Marine Delay in Start-Up – to protect against lost profit plus extra expenses due to the delay in arrival of critical components; for instance, due to thrusters being dropped into the water during loading of vessel – causing a 3-month delay in project (due to back-order of specific thrusters required per specifications)
  3. Hull & Machinery & Protection & Indemnity Insurance – to protect against All Risks of loss of or damage to the vessel / rig – and liabilities resulting from the vessel / rig – during transport after completion at Yard (for instance, if delivery is not ex- yard, but rather at final drilling Site)
  4. Hull & Machinery & Protection & Indemnity Insurance – to protect against All Risks of loss of or damage to any vessels / crane barges that might be used to assist in the construction of the vessel / rig
  5. Liquidated Damages Insurance – to protect against penalties for failure to satisfy an agreement; for instance, for late delivery of unit due to losses of a BAR nature
  6. Political Risk Insurance – to protect a foreign entity against loss suffered due to political risk nature (including Confiscation, Nationalization, Expropriation, Selective Discrimination, Contract Frustration, Inconvertibility & Non-Transfer of funds, etc.)
  7. Professional Indemnity (PI) Insurance – to protect against legal liability arising from any professional negligent act, error or omission in rendering or failing to render professional services by an Assured. We recommend that you look into the design and engineering work and contractual requirements and track records involved in the rig, and see what protections are already in place.

The standard requirements of both Owners and Shipyard :

  1. Workmen's Compensation / Employers' Liability as required by applicable statute
  2. Auto Liability as required by applicable statute

6. Coverages available for the shipyard post- delivery (relating to the construction phase):

  1. Following delivery of a unit to an Owner, usually Maintenance & Discovery coverage is purchased.
  2. Warranty coverage is also possible.

What is the difference between Maintenance Coverage of a Builder's Risk Policy and Warranty Coverage?

The Maintenance Cover is simply an extension of the Builder's Risk policy, which in this case survives delivery of the vessel to the owner, with coverage being no broader than that contained elsewhere in the policy, subject to all of the conditions and exclusions of that policy .

The Warranty Coverage is "back-to -back" protection of the Assured's contractual Warranty Clause to Owner. This means that the Warranty Clause from the contract actually becomes the insuring condition of the Warranty Policy.

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Choosing the Best Car Audio System

The basic components of a high-quality car stereo system are an AM / FM tuner, a CD player, an amplifier (optional but recommended) and great speakers.

Rule: No auto audio can equal the performance of fine home equipment. The car compartment is small, besieged with engine and traffic noises, and surrounded with competing electrical signals. And all of this in a moving environment. A welter of technical and personal choices dictate the final package.

General guidelines: Shop around. Car audio components are often discounted. Check mail-order houses and the Internet for the best buys.

Essential: Deal with reputable businesses and buy name brands. Make sure you can exchange or return components in case they prove incompatible or do not fit into the car. Remember each unit must be installed and may require custom mounting accessories. Keep personal tastes in mind. Rock and country music fans usually prefer stronger bass ranges. Classical music requires good mid and treble.

How to allocate your spending: 40% to 50% for tuner / tape player, 25% to 30% for amplifier, 25% to 30% for speakers (unlike home gear, for which half the recommended expenditure may go for speakers alone).

General recommendations: Components are a better deal than manufacturer-installed original sound equipment. Good manufacturer-installed gear can cost $ 1,000, a price that will usually bring you far better sound if spent on components. Try to find a dealer that has set up a sound room to hear and compare different systems.

New-car buyer strategy: Buyers planning to purchase components should insist on a delete-option clause, eliminating the installed radio cost.

In-dash versus under-dash components. Under-dash components are easily installed.

Overriding disadvantage: A thief can slip out the under-dash gear as easily as an ashtray. Choose in-dash tuner / CD players unless you want to stow the components in the trunk each time you leave the car. (If you still prefer an under-dash system, Sony components are top-notch ones.)

Amplifiers: Most auto-sound packages benefit from amplifiers that strengthen bass and high-treble tones.

Problems: Amplifiers are bulky and often must be installed under a seat or in the trunk. Unless your tuner has a bypass circuit permitting you to plug into the preamplifier, your costly amplifier will only boost the distorted output of the built-in amplifier.

Smart buying: Look for amplifiers measuring power in watts (w) per channel in terms of distortion (THD). Goal: About five watts per channel at 1% distortion or less. To get this, the amplifier may require 50 watts per channel because few operate at better than 10% efficiency in a car.

Bi-amplifiers: They offer separate power boosts for bass and treble ranges. Bi-amplification may be called for when separate bass and treble speakers are installed.

Speakers: Speakers must be compatible with amplifiers. Their power capacity should be slightly higher than amplifier. Example: Get 60w speakers for a 50w / ch amplifier. One way to be sure of speaker / amplifier compatibility is to purchase them as a package.

Stereo sound requires at least two speakers. Many enthusiasts choose four. Non-directional bass speakers are best placed in the factory cutouts in the rear window shelf. Next best placement: In rear doors. Treble speakers can be mounted in front door panels or under dash.

Installation: Unless you are highly skilled electronics hobbyist, have the auto-sound system professionally installed. Allow $ 150 to $ 200 for installation, and get a satisfaction guaranteed agreement.

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10 Common Reasons Why Medical Claims were being Denied and your Action Plan

(1) Incorrect patient's information ( insurance ID #, date of birth) If you are submitting electronic claims, AVOID entering patient's insurance number with characters like an asterisk (*) and dash (-) in between the alphanumeric numbers because these characters can be recognize by electronic as unrecognizable. Just check on this issue with the clearinghouse or your service provider. Always make a copy of your patient's primary & secondary insurance card on file (copy front and back!). Make sure to get a copy of their new card (if there is a change).

(2) Patient's non-coverage or terminated coverage at the time of service may also be the reason of denial That is why, it is very important that you check on your patient's benefits and eligibility before see the patient (unfortunately, I have seen practices who does not check on benefits and eligibility on their patients so they end being not paid for the service they rendered to the patient)

(3) CPT / ICD9 Coding Issues (requires 5th digit, outdated codes) — be careful

also with your secondary code! Claims may be denied even if the problem was just because of the secondary CPT / ICD9 code! Again as I previously pointed out with my other articles on tracking your claims, with this problem, discuss solving the coding error rather than how much you want to get reimbursed. Most of the insurance companies will help you with codes (in fairness !!) and they also inform you on outdated codes, or codes that requires a 5th digit. Be nice with the claims department! (At least you try!)

(4) Incorrect use of modifiers! (Be careful with bilateral procedures !, modifiers for professional and technical component, modifiers for multiple procedures, postoperative period, etc.)

(5) No precertification or preauthorization obtained (if required) It is so hard to file an appeal when the claim or service was non-precertified. Avoid it from happening!

(6) No referral on file ( if required) Note: HMOs always requires a referral! (Remember that!)

(7) The patient has other primary insurance or the patient's claim is for workman's comp or auto accident claim! It is the responsibility of your front desk staff to get all the necessary information before the patient can be seen. Remember that if this is a workman's comp or an auto accident claim, you need a claim number and the adjustor's name. Services are always preauthorized!

(8) Claim requires documentation & notes to support medical necessity A well documented medical records is a good practice!

(9) Claim requires referring physician's info (with UPIN ofcourse! -this will be soon replaced by an NPI or the National Provider Identification number)


(10) Untimely filing Unfortunately most of the insurances does not accept your billing records on your office computer that shows that date (s) you billed the insurance! They want a receipt from your electronic receipt or for postal mail, obviously they want a receipt too! a tracking number maybe? certified letter receipt? If you are submitting claims by electronic, make sure you generate transmission reports / receipts. Your reports must read "accepted" and not "rejected". File all these transmittal reports / and receipts and a very safe place! If you are sending claims by paper or postal mail, it is a good idea to send your claims as certified mail with tracking number, keep your receipts !!

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Do I Need Uninsured Motorist Coverage on My Auto Policy If I Have Medicare Or Health Insurance?

This is a very common question that we encounter in our practice. I've even heard of insurance agents who expressed the opinion that people do not need uninsured motorist coverage on their auto policy if they have health insurance or Medicare. The reasoning seems to be that following an accident their medical bills would be covered. Unfortunately, this reasoning fails to take into consideration all of the other benefits available from uninsured motorist coverage to someone who's been seriously injured in an auto accident or to the estate of someone who has been killed.

The purpose of uninsured motorist coverage is to compensate the insured for all of the elements of damage they would have been entitled to receive from the person causing the accident, but who carried no bodily injury insurance, or very low limits of coverage. In Florida, those damages would include: pain, suffering, disability, scarring, disfigurement, mental anguish, loss of the enjoyment of life, lost earnings and earning capacity, as well as unpaid medical expenses incurred in the past, and those to be incurred in the future. Of this list of damage items, the only ones which would be covered by health insurance or Medicare would be "covered" medical expenses. Beyond having their medical expenses paid, someone carrying no uninsured motorist coverage, who was struck by an uninsured driver, would receive no compensation for all of the other elements of damage described above.

No one ever believes they will be involved in a serious motor vehicle accident. But every day throughout the state of Florida, hundreds of people are seriously injured who also believed it would never happen to them. Following a serious accident, the injured person will immediately begin to consider, who will compensate them for the substantial losses they have incurred and those which will be incurred in the future. Losses such as pain, suffering, loss of enjoyment of life, as well as loss of earning capacity and earnings are very commonly encountered in relatively routine motor vehicle accidents. In the more serious accidents, all of these losses may be incurred, particularly those which involved the death of a loved one. People naturally become angry and frustrated when they have been struck by an uninsured driver, only to discover their own policy of insurance does not include uninsured motorist coverage.

There is something else to consider about carrying only Medicare or health insurance. If there is any liability coverage available to provide compensation of one's injuries, even though it may be woefully inadequate, Medicare and virtually all health insurance policies, have reimbursement rights. Federal statutes require reimbursement of benefits provided by Medicare and employer sponsored health insurance plans when the injured person receives compensation for their injuries. Most other health plans contain reimbursement rights which are regulated under state law, including Florida. This means that when someone's health insurance or Medicare provides benefits to them following an accident, those benefits are subject to being paid back if the injured person is successful in getting even minimal compensation from the party responsible.

Therefore, the only way someone may protect themselves is to carry the maximum amount of uninsured motorist coverage they can afford. We urge our clients to examine their declaration sheet on their auto policy, determine what coverage they actually have purchased, and call their agent to get a quote for uninsured motorist or additional uninsured motorist coverage.

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Courier Delivery Services Or In House Delivery?

The following may help you to decide whether to use your own (in-house) delivery vehicle or use outside courier delivery services, such as a custom, immediate, or route delivery service. This analysis is based on monthly costs to operate a delivery vehicle. Also keep in mind:

The cost of a vehicle is not what you pay for it, but the total cost when you are finished using it. First, determine the cost of operating your own delivery vehicle:

– Vehicle cost (Lease or Purchase)
– Fuel cost (Gasoline or Diesel)
– Insurance (Commercial and Liability)
– Maintenance (Repairs and Upkeep)

Next, determine the employee cost to operate the delivery vehicle:

– Wages and Salaries (State and Federal income taxes, including FICA)
– Federal and State fees (Workers Compensation, Unemployment insurance, etc.)
– Employee benefits (Health, Life, Dental insurance, 401k, 403b, etc.)
– Fill-in replacement (Vacation, sick leave, etc.)

Then, determine how the delivery vehicle is to be utilized:

– On Demand, (deliver immediately)
– Daily Route (delivery once or twice a day)
– Weekly Delivery (deliver the same day each week)

After the total cost is determined, divide the number of deliveries per month by the total monthly cost of the service provided. This number will be the average cost per delivery of each delivery. If you also keep track of the mileage each month, you can easily determine the cost per mile to operate the vehicle. Knowing your cost per mile will help you compare your cost with local courier delivery services as many charge by the mile after a base charge.

Once you have the in-house cost to provide delivery services to your customer, contact a local courier delivery services company to compare rates to determine whether to keep your existing delivery in-house, or contract with your courier delivery services company. Delivery service companies are always looking for new clients and could help analyze your current delivery needs and quite possibly save you time and money in the process.

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