Rose McGowan
Contents contributed and discussions participated by Rose McGowan
Health Insurance for Young Adults - 1 views
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As we grow older, our responsibilities add up. Having a health insurance should be one of the priorities that we should think of. By the time you are old enough to fend for yourself, you are then required to get an insurance. However, many young adults are still confused on its importance. 1. It may be Illegal When you are living in the United States, Affordable Care Act (ACA) compels you to purchase insurance. Going without insurance for three months would force you to pay a penalty of $325 or 2% of your monthly income, whichever is higher. In developing countries, uninsured individuals have the option to purchase from private companies but laws are already drafted for completion. In cities like Jakarta, Indonesia and Bangkok, Thailand, more than half of their unemployed population goes uninsured. 2. If you are a full-time employee, your employer should provide you with insurance Most companies require employees work for set period before benefits can be provided. It usually takes 3-6 months in a probationary period before regularization, by which insurance is given. It is in any law in any states and government to mandate to every employer to provide employee benefits. 3. Your parents may still be able to cover you Individuals under the age of 26 can still be listed under their parents' coverage. They can still cover even a modest premium cost. 4. You can do it alone If you are not insured under your parents' plan or purchasing insurance under your employer is not an option, you have the choice to purchase your own insurance from trusted private companies. If you are buying online, just make sure you
Medical Insurance for Expatriates - 1 views
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Expatriates may find it hard to avail of health insurance when they are in a foreign place. The system varies from that of your own nation and customs of availing is a far cry especially in developing nations. Luckily, developing countries like Indonesia and Thailand are starting to expand its insurance's scope to a more international level, catering to both local and foreign individuals. Companies operating in Jakarta, Indonesia, for instance, realize the importance of a comprehensive medical plan to cover sickness and accidents that happen to the staff that they hire. Westhill Insurance Consulting is also aware of the struggles faced by expatriates when it comes to getting insurance. What preparations do you do then? 1. Find out before you come The company who hired you and the person you are working for should provide medical insurance for you and your family members just as they do with local folks. Ask for details from your employer to ensure that your policy will adequate cover your family members for sickness, accidents or emergencies, on home leave and when you are visiting other countries for work-related purposes. If you are joining a new company, remember that they may never love you more than when you first join. Do not rely on promises that medical insurance coverage will be sorted out when you arrive. It could be the case that what the company considers ideal coverage may not meet your expectations. Be sure before you arrive that you understand what medical coverage your company provides for regular medical concerns, major medical situations such as surgery or deliveries,
Expansion of Health Insurance to Developing Nations - 1 views
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With the challenge of today's generation, health risk is greatly increasing. Today's citizens have greatly recognized the danger of going out every day. Health insurance is also in demand in the market and is considered as one of the most necessary insurance to have.
Developing nations are already increasing its insurance economy and even building its own campaign towards the totality of health insurance patrons.
According to a report released by Westhill Insurance Consulting, health insurance has already been accepted as a necessary part of each household.
Indonesia is one of developing nations who has proven too slowly adapt health insurance in its system. With over 200 million citizens flocking on the national health insurance registration in Jakarta, Bali, Sumatra and major places in the country, the government has been proud to predict that it may be possible to see all of the archipelago's population already avail of health insurance.
To cater to rural areas of developing nations on the other hand, reliable, always‐on broadband wireless connectivity makes a new health care model possible: instead of asking the patient to go to the nearest clinic or hospital, the mobile health care worker reaches out to the patients where they live and when they need care, bringing access to a broad set of medical resources through voice, data, and video applications.
The only challenge in pursuing health care insurance in developing nations is the fraudulent deeds happening among their people because of the lack of security and loose protection from the authorities.
To prevent these scams from happening and keeping more victims from losing their hard-earned money for a non-existent medical assistance, many companies and non-profit organizations are continuously seeking reforms. Universal Health Coverage (UHC) initiatives have sought to create awareness in and provide guidance to countries on how to improve the design and functioning of their health systems based on evidence of what works for achieving the goal of universal coverage. Meeting this goal is, however, challenging, because the available evidence rarely explores the causal link between the design features of these UHC schemes and the outcomes observed, and substantial heterogeneity exists regarding the robustness of the available evidence.
UHC reviews and indicates possible intervention to both low and middle-income countries for improvement. Affordability is currently the main concern for the organization to both solve the problem of the small number of health care insurance holders and keep scams from happening.
Hopefully, more solution can be presented as we look forward for a healthier life in the near future.
Clinical Trials Supported by Insurance - 1 views
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Trials involving human patients are crucial to the advancement of clinical science. But they're not without risk. Fortunately, insurers are willing to cover them. Westhill Insurance Consulting, one of the most trusted on-line insurance consultant that offer consumer information on reasonably priced health and medical coverage has these following things to review if you are planning to take part in a clinical test. Challenging trials One challenge for underwriters is the relatively small premium base measured against a trend for higher [insured] limits to be requested. Clinical trials policies normally have "claims made" wordings which means that insurance coverage does not automatically extend beyond the trial dates. The potential gap is where you arrange insurance, let the policy end and have no insurance for an event which may occur sometime in the future that can be attached to the clinical trial. Serious problems in clinical trials are rare, as Rossano points out. "But what I would say is that clinical trials are not without risk. The risk of a clinical trial is that the human body is very complex and in rare cases there can be unforeseen outcomes, as happened in cases like TeGenaro."
The Role of Health Insurance to Family Planning - 1 views
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World Health Organization (WHO) has stated that universal health coverage - ensuring that all people obtain health services they need without suffering financial hardships when paying for them - is a global priority for this year. They also declared that universal health coverage as "the single most powerful concept that public health has to offer".
Several developing countries such as Indonesia, the Philippines, Rwanda, Vietnam, Kenya and Nigeria among others have demonstrated a strong commitment to universal health coverage, with many others slated to follow suit. Jakarta, the capital of Indonesia is already paving its way to offering a more extensive health insurance coverage that can cater different places in the inter-island archipelago.
Westhill Insurance Consulting Company, your guide to health insurance concerns located in Australia has been in partnership with varied insurance companies which has the goal of expanding the reach of health insurance.
Given this momentum, it is time to think critically about how the goals of universal health coverage can be advanced through health insurance to ensure that women worldwide are empowered to choose the size, timing, and spacing of their families.
Health insurance pays for all or part of medical or surgical expenses for the insured, mitigating out- of-pocket payments as a barrier to health care and providing financial risk protection against catastrophic health expenditures. Different types of insurance models have varying funding sources and provider payment. Many countries have some form of insurance program in place and coverage has increased considerably.
Many reviews say that it would be better for insurance companies to include family planning in their policies and terms especially in over-populated countries like Indonesia which remains the 4th most populous in the world and China which tops the chart. It is well established that family planning results in benefits beyond reducing unmet need and lowering fertility-benefits such as fewer maternal and child deaths and complications from abortions; and improved nutrition outcomes among women, infants, and children. Given the high cost of addressing maternal and child health, these benefits can lead to considerable savings for health systems and insurance providers. Critics have complaints though that if this be passed, couples can make this reason for pre-marital sex which continues to be a moral issue in countries centered by this insurance idea.
When developing insurance programs, governments and health insurance providers must carefully decide on a benefits package that clearly describes the types of services covered, along with levels of coverage and any applicable exclusions and/or limits on services. Since lack of access and inability to pay are important reasons women do not use family planning, inclusion of family planning services in health insurance programs could increase uptake. The Commission on Macroeconomics and Health has suggested criteria for choosing essential health interventions. Family planning is a strong match to the key criteria because it is a technically effective intervention, can be delivered successfully, addresses health issues that impose a heavy burden on society, and has benefits beyond the intervention itself.
HMO vs PPO - 1 views
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Most of us who are employed know that we have corresponding health insurance. For others who choose their own insurance, agents might have explained what should be provided and covered for our policies. One of the things that we should be aware of is the type of a managed care plan we need: either an HMO or PPO to avoid complaints, frustrations and disappointments added to our consultation to the doctor. If this is the first time you are hearing this, then, you are not alone. Some insurance are already fixed that agents do not care to mention it anymore.
Westhill Insurance Consulting took the liberty to differentiate each one from the other.
HMO actually stands for Health Maintenance Organization while PPO is an abbreviation of Preferred Provider Organization. Less common are point-of-service (POS) plans that combine the features of an HMO and a PPO. In developing cities like Singapore, Kuala Lumpur, Malaysia, Jakarta, Indonesia and Beijing China, HMO is mostly used by employers for their health care insurance.
To put into an outline, here are the facts that are needed to be reviewed and considered between the two:
Do I need to choose doctors, hospitals and other providers?
* HMO: you must choose doctors, hospitals and other providers
* PPO: you can choose doctors, hospitals and other providers.
Do I need to have a Primary Care Physician (PCP)?
* HMO: Yes, your HMO will not provide coverage if you do not have a PCP.
* PPO: No, you can receive care from any doctor you choose. But remember, you will pay more if the doctors you choose are not "preferred" providers.
How do I see a specialist?
* HMO: Referral is needed from your PCP to see a specialist or if you have to undergo other special test exams such as x-rays, except in emergency situations. Your PCP also must refer you to a specialist who is in the HMO network.
* PPO: You do not need a referral to see a specialist. However, some specialists will only see patients who are referred to them by a primary care doctor. And, some PPOs require that you get a prior approval for certain expensive services, such as MRIs.
Do I have to file any insurance claims?
* HMO: All of the providers in the HMO network are required to file a claim to get paid. You do not have to file a claim, and your provider may not charge you directly or send you a bill.
* PPO: If you get your healthcare from a network provider you usually do not need to file a claim. However, if you go out of network for services you may have to pay the provider in full and then file a claim with the PPO to get reimbursed. The money you receive from the PPO will most likely be only part of the bill. You are responsible for any part of the doctor's fee that the PPO does not pay.
Critical Health Insurance Plans for Critical Health Ailments - 1 views
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There are a lot of health care insurance nowadays with thousands of healthcare insurance companies scattered around the world. Individuals and organizations are slowly starting to appreciate their importance in today's practical yet expensive lifestyle and health demands. If you are a person living with cancer or a survivor or with any other critical ailment, it is important to make sure that the health insurance plan you choose covers the prescription drugs you mostly need.
Westhill Insurance Consulting gives out warnings on the spread of fraudulent insurance that are emerging targeting the need of cancer patients for insurance. Reports have already been shown in the developing city of Jakarta, Indonesia and Mumbai, India. Here are the tips that we must remember when we avail of critical health insurance for critical health ailment:
All new health insurance plans must provide a benefit package that includes prescription drugs, but the actual drugs that are covered will vary by plan. As you think about the kind of health insurance coverage you or a family member needs, look carefully at the kind of prescription drug coverage the plan offers to make sure the drugs you take will be covered. Because many cancer drugs can be extremely expensive, so making sure that your plan covers the specific drugs you take may save money.
Things You Need to Consider
o >Medications You Take: The first step is to make a list of all of the prescription medications you currently are taking, including pain medication and anti-nausea drugs. You will need this information to be able to compare the coverage offered by different insurance plans.
o Drug Formularies: Most insurance plans have a formulary - a list of the drugs the plan covers. Check the formulary of each insurance plan you are considering to make sure that it includes the medications you are taking. You can find out your plan's formulary by checking their web site or calling the plan directly. Agents can also help you determine which health plan to choose.
o Cost Sharing: You will want to carefully compare the cost sharing different plans charge you when you fill a prescription drug. Some plans charge co-pay, which is a flat rate the patient pays per prescription. Other plans charge a coinsurance, a percent of the total cost of the drug owed by the patient. For cancer drugs, coinsurance will almost always be more expensive than co-pay.
Finding Private Health Insurance - 1 views
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Many of us have to rely on the company's health care insurance provider. Lucky for those people who can stay in one job for years. How about those people who jumps from one venture to the other? Westhill Insurance Consulting has faced queries on the best alternative whenever unemployment comes near. Private health insurance is the main source of health coverage for the majority of people in the United States alone. For elderly citizens and eligible children and families from low-income households, public programs are the primary source of health cover. If you are not covered by a publicly funded program, or if your coverage is only partial, you will need to have some kind of private health insurance. In developing cities like Tokyo, Japan, Seoul, South Korea, Jakarta, Indonesia and Singapore, millions of people have found themselves with no health cover at all. Reviews show that uninsured people reaches up to 46 million. Tens of millions more have inadequate insurance.
The Best Fit in Healthcare Insurance - Westhill Consulting Insurance - 1 views
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With the widespread of insurance nowadays, people are confused which one is legit and which one is a fraud; which can offer better and which one cost less. Choosing the right health coverage has never been easy, and the health reform law has made things more complicated. Besides sorting through differences in premiums, deductibles, and copayments, you need to consider new provisions in the law that have recently kicked in and could impact your coverage for the coming year. Westhill Insurance Consulting can help you clear away any confusion, doubts and complaints. Health insurance should cover any medical need you may have, now or in the future. Buying insurance on your own used to be riskier because many plans didn't cover important things such as prescription drugs or mental health care. Every kind of health insurance must now cover preventive care, with no deductibles, co-pays, or other types of out-of-pocket expenses. That includes Pap and cholesterol tests, mammograms, immunizations, and colonoscopies when age- and condition-appropriate. But even though you no longer have to worry about your basic health care needs being covered, you'll still have to navigate lots of other confusing choices. That's true even if you get coverage through a job, because more than half of workers have a choice of two or more types of health plans. 1. Do you want to pay for care now or later? All health plans have to come up with enough money to pay for the medical expenses of their members. You can choose to collect most of the money up front in the form of premiums. If you have a high premium, you'll pay a smaller share out of your own pocket, in the form of deductibles, co-insurance, and co-pays. Or plans can go the other way, charging smaller premiums but asking you to pay a bigger share on your own. 2. Are you OK with a small network of docs? Doctors and hospitals accept lower fees from insurers if they know they'll be part of a small, o
Lapses in Insurance Coverage - 1 views
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Insurance has been around since people have realized it should be. Yet sometimes, we cannot avoid not paying for our premiums especially when we encounter financial instability. These are called lapses. Westhill Insurance Consulting gives you the outlines of what you should review once you missed paying your premiums.
Grace Period Must Happen Before Lapse
To prevent a life insurance policy from lapsing each and every time a premium payment is slightly late, every state in the country requires that a life insurance policy first go through what is known as a grace period after a payment is missed. This is a period of time (usually 30 days) where despite the missed payment; the insurance policy will still provide coverage and make a full payout if the insured dies.
Only after the grace period has passed without receiving the due premiums can the life insurance company consider the policy to be lapsed. Once a life insurance policy lapses the life insurance company is not under any legal obligation to pay the beneficiaries if an insured person passes away.
Most Policies Can Be Reinstated After Lapsing
After a policy first lapses, the owner may have the option to reinstate the policy. You want to make sure that you reinstate your policy as quickly as possible after a lapse. Different companies have different rules for reinstatement so you shouldn't file a complaint or burst into frustrations when your insurance company refuses to reinstate your policy as it should already be stated when you were reading the terms before you signed for the coverage.
Importance of Reinstatement Period Lapse
The reinstatement period is very important to policy owners and insured persons for a couple of reasons. The first reason is as discussed, the insured person may not need to go through the underwriting process. If a person has had a major health change, he/she may not necessarily be aware of the change. The underwriting process may uncover more about a person's health than they ever knew, for better and worse. Avoiding underwriting when possible almost always leads to lower insurance premiums.
The second reason the reinstatement period is very important is that even with the same health rating, a new life insurance policy will always be more expensive than an old policy, because the insured person has aged. The older the insured person, the higher the rates will be, all else being equal. The bottom line is: Reinstating a life insurance policy rather than taking out a new policy will save money.
Reinstatement Will Cost More than One Month Premium
After a policy has lapsed, a larger payment must be made to reinstate the policy. It is in the best interest of a policy holder never to let a policy lapse. Developing cities like Bangkok, Thailand, Jakarta, Indonesia and Kuala Lumpur, Malaysia are strict in reinstatement and its cost as personal insurance are rare.
References:
https://groups.diigo.com/group/westhill-healthcare-consulting
https://www.linkedin.com/groups/Westhill-Consulting-Insurance-5110019
Insurance in a Divorce - 1 views
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Divorce is one of the most devastating events in one couple's life. While most divorcing couples focus on the delicate and often difficult issues of child custody and dividing assets, breaking up can be hard to do in terms of your insurance policies, too. Whether the policies are in place for protection or as an investment, divorcing spouses need to review them in the context of their new financial circumstances. Westhill Insurance Consulting has listed some matters to be prioritized during this delicate time.
1. Life insurance
Your first step should be to check the beneficiaries on your life insurance, whether you have term or permanent policies. People sometimes forget the existence of their life insurance policies, yet often the amount of money involved is higher than their other assets. If you forget to change the beneficiary of your policy and you pass away, your ex-spouse could get the money instead of your new spouse."
Melody Juge, managing director of Life Income Management in Flat Rock, N.C., says splitting spouses should negotiate ownership of life insurance policies as part of the divorce settlement.
"If your spouse has an insurance policy that you're depending on to take care of you and your kids if he dies, you should have (the) ownership changed to yourself instead of your spouse," says Juge. "If not, your spouse could change the beneficiary or simply stop paying the premiums."
2. Health insurance
Many couples share health insurance under one spouse's employee benefits package; a divorce will require a policy change.
When you work and have previously been covered by your spouse's company, you can generally obtain health insurance through your own employer after a divorce.
Also, the federal law known as the Consolidated Omnibus Budget Reconciliation Act, or COBRA, allows a person going through a divorce to stay on a spouse's group policy for a limited time. But you'd have to pay the full premium yourself. Developing cities like Kuala Lumpur, Malaysia, Singapore and Jakarta, Indonesia are now creating an act similar to COBRA for divorce protection.
3. Home and car insurance
Liability insurance policies for your home and car are particularly important to maintain during and after a divorce.
Divorcing spouses should immediately notify their insurance companies if an asset such as a car or home changes ownership to avoid filing more complaints and causing more crease.
4. Long-term care insurance
Hook says long-term care insurance policies are individual insurance policies, so there would not be much impact from a divorce. But some insurance companies offer a discount for covering a married couple, and that would be eliminated after a split.
Premiums for long-term care insurance should be estimated as part of your expenses during the divorce settlement. Hook suggests that divorcing spouses in their 50s who don't have long-term care coverage should be sure to purchase some.
Westhill consulting Insurance - Tips for handling early-year medical expenses - 3 views
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The clock on insurance deductibles reset on Jan. 1, and that means big medical bills are in store for some. Patients may be required to pay thousands of dollars before their health care coverage kicks in. Insurers typically begin or renew policies in January, and that means customers could face some daunting cost-sharing requirements in the first few months of the year. That's especially true if they need surgery or have a particularly expensive prescription. Deductibles topping $3,000 are common among plans sold on the health care overhaul's public insurance exchanges, which provide coverage for millions. Companies also have been raising deductibles for years on employer-sponsored health plans, the most common form of coverage in the United States. Plus cost-sharing requirements for Medicare prescription drug coverage renew every year. All this adds up to a business boon for organizations like the Patient Access Network Foundation, which offers grants to help cover prescription costs for dozens of life-threatening, chronic or rare diseases. The nonprofit had to hire about 80 temporary employees to help handle the heavy workload it receives at the start of the year. It fielded 4,000 calls a day last month, double its normal total. "Everybody who works doing what we do has the same challenge," CEO Daniel Klein said. Klein's foundation is one option patients can turn to if too many expenses hit at the start of the year. Here are some other tips. Understand your coverage: You can't prepare for medical expenses until you know how big the bills might be. Your insurance should come with a plan summary that lays out important numbers. Start by understanding your plan's deductibles, which can differ significantly depending on whether care is received inside or outside the insurer's network of providers. If you take prescriptions, double check how much they will cost. Drug coverage is commonly divided in
Insure your Business in the Clouds - 1 views
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In the turn of the most technologically advanced era yet come more and more advanced fraudulent acts as well. The genius invention of cyber insurance have helped small, medium and large scale businesses in securing their data, shared information and hacked systems. These cyber insurance have already reached not only the leading nations in the world but developing cities and countries as well such as Singapore, Jakarta, Indonesia, Kuala Lumpur, Malaysia, Beijing, China, Tokyo, Japan and many more. If you are one of those who have individual experience with spam, scams, hacks and other illegal computer malpractice, then we at Westhill Insurance Consulting would want to enumerate top ten reasons why cyber insurance is important:
1. Data is one of the most important assets yet it is not covered by standard insurance policies. It is many times worth as the physical product or service that a company is offering. Yet, most business owners do not realize the worth of these data and do not have a standard policy when the files are corrupted, damaged or destroyed. A cyber policy can provide comprehensive cover for data restoration and rectification of a loss no matter how it was caused and up to the full policy limits.
2. Systems are critical to operating your day to day business but their downtime is not covered by the standard business operations interruption insurance. All businesses rely to available systems to operate and organize their business. In the event of a hack attack, scam or computer virus a traditional business interruption policy would not respond. Cyber insurance can cover for the loss of profits associated with a system outrage that is caused by a non-physical peril like a computer virus or service attack.
3. Cyber crime is the fastest growing crime in the world but most attacks are not covered by the standard property and crime insurance. New crimes and complaints are emerging every day. With the use of the internet means that they are exposed to the world's criminals and is vulnerable to attack any time of the day and night. Cyber insurance can provide comprehensive crime cover for a wide range of electronic perils that are increasingly threatening the financial resources of today's businesses.
4. Your reputation is your number one asset and it is a must that you are to insure it. Any business is built on its reputation. Although there are indeed some reputational risks that cannot be insured, you can insure your reputation in the event of a security breach. When your systems, files and data have been compromised, you run a very big risk of losing the trust of your most loyal clients which can harm not only your business but your whole life as well. Cyber insurance can not only help pay for the costs of engaging a PR firm to help restore this, but also for the loss of future sales that arise as a direct result of customers switching to your competitors.
More insurance consultations can be found at http://www.westhillinsuranceconsulting.com/blog/. Learn more about insurance for your family and your own welfare.
The 5 Best Money Lessons We Learned Last Year - 1 views
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1. It's Smart to Prepare for a Breach How many data breaches from 2014 can you name? The freshest one in your mind is probably the Sony hack, but there were also attacks on Home Depot, Staples, Dairy Queen, P.F. Chang's the list goes on. Credit.com Co-Founder and Chairman Adam Levin recently wrote about the most important lessons you can learn from the Sony hack, encouraging consumers and companies to prioritize data security and behave with the knowledge that your personal information and correspondence could be exposed at any time. Prepare for the possibility of fraud by monitoring your credit, regularly reviewing account activity and knowing what to do if your personal information has been stolen. Do what you can to strengthen your data security, but know that so much of it is beyond your control, so the best thing you can do is know how to react to a breach. 2. Communication Is Crucial to Getting Debt-Free as a Couple We published several success stories about getting out of debt, but some of the most memorable involved couples working together to conquer their finances. The stories had similar themes: Ellie Kay married her husband without knowing about his $40,000 of consumer debt, and Ja'Net Adams was unaware her husband took out student loans to pay for college. Both families eventually hit breaking points where they realized debt was holding them back, and they needed to make drastic changes to get rid of it. Getting out of debt is never easy, and the more people who are involved, the more complicated it can be. At the same time, having someone to work through the challenges with you can be extremely helpful. Adams' and Kay's stories highlight two crucial elements of getting debt free: staying committed to a plan and remaining open and honest about the process' progress and challenges. Those lessons apply to any personal finance goal, whether you're planning with a family or on your own.
Data breach trends for 2015: Credit cards, healthcare records will be vulnerable - 1 views
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The data breaches of 2014 have yet to fade into memory, and we already have 2015 looming. Experian's 2015 Data Breach Industry Forecast gives us much to anticipate, and I've asked security experts to weigh in with their thoughts for the coming year as well. Experian highlights a number of key factors that will drive or contribute to data breaches in 2015. A few of them aren't surprising: Organizations are focusing too much on external attacks when insiders are a significantly bigger threat, and attackers are likely to go after cloud-based services and data. A few new factors, however, merit your attention. First, there is a looming deadline of October, 2015 for retailers to upgrade to point-of-sale systems capable of processing chip-and-PIN credit cards. As banks and credit card issuers adopt more secure chip-and-PIN cards, and more consumers have them in hand, it will be significantly more difficult to clone cards or perpetrate credit card fraud. That's why Experian expects cybercriminals to increase the volume of attacks early in 2015, to compromise as much as possible while they still can. The third thing that stands out in the Experian report is an increased focus on healthcare breaches. Electronic medical records and the explosion of health or fitness-related wearable devices make sensitive personal health information more vulnerable than ever to being compromised or exposed. The risk of health related data being breached is also a concern voiced by Ken Westin, security analyst with Tripwire. He pointed out that part of the reason that retail breaches have escalated is because cybercriminals have developed the technologies and market for monetizing that data. "The bad news is that other industries can easily become targets once a market develops for the type of data they have. For more info: Westhill Insurance Consulting Data breach trends for 2015: C
Medicare Overbilling Probes Run Into Political Pressure - 1 views
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When investigators suspected that Houston's Riverside General Hospital had filed Medicare claims for patients who weren't treated, they moved to block all payments to the facility. Then politics intervened. Rep. Sheila Jackson Lee, a Texas Democrat, contacted the federal official who oversees Medicare, Marilyn Tavenner, asking her to back down, according to documents reviewed by The Wall Street Journal. In a June 2012 letter to Ms. Tavenner, Rep. Jackson Lee said blocking payments had put the hospital at financial risk and "jeopardized" patients needing Medicare. Weeks later, Ms. Tavenner, administrator of the Centers for Medicare and Medicaid Services, instructed deputies to restore most payments to the hospital even as the agency was cooperating in a criminal investigation of the facility, according to former investigators and documents. "These changes are at the direction of the Administrator and have the highest priority," a Medicare official wrote to investigators. About two months after that order, Riverside's top executive was indicted in a $158 million fraud scheme. The hospital was barred from Medicare this May, and the CEO was convicted in October. What happened at Riverside General Hospital shows how political pressure from medical providers and elected officials can collide with efforts to rein in waste and abuse in the nearly $600 billion, taxpayer-funded Medicare system. More than a dozen former investigators and CMS officials said in interviews that they faced questions from members of Congress about policy changes or punitive action affecting providers or individual doctors.
There Is a Reason We Never Crack Down on Medicare Fraud - 1 views
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Did you know there's a government program that gives more than $60 billion a year to felons and voracious, unscrupulous hospitals and doctors?
There is: improper health-care payments. In FY 2012, Medicare fee-for-service, Medicare Advantage, and Medicaid produced $61.9 billion in improper spending. $30 billion of that is Medicare alone. It should anger us, obviously, but also worry us, because the federal government is expanding its reach into the health-care market as we speak.
Congress is doing very little to address all that fraud and waste and the little it does is very ineffective. Nobody in the health care system has a real incentive to crack down on fraudulent or mistaken payments, so nothing gets done about it. In an eye-opening piece last year, Citizens Against Government Waste's Leslie Paige laid out the efforts by health-care providers and some lawmakers from both parties to slow down the rate of improper payments through recovery audit contractors (RACs).
This means that wasteful and fraudulent spending will continue to cost taxpayers billions - when it doesn't have to, or certainly doesn't need to in the same proportion.
It has other tragic effects too. Case in point (via Michael Cannon):
U.S. Attorney Barbara McQuade will seek life in prison for what she called "the most egregious" health care fraud case she has ever seen. McQuade said that in addition to insurance fraud, which involved a $35-million Medicare fraud scheme from 2009 until the present, Fata also harmed, and in some cased subsequently killed, his patients with dangerous chemotherapy drugs they did not need. According to government records, Fata's medical practice included 1,200 patients. The formerly prominent cancer doctor will be sentenced in February before U.S. District Judge Paul Borman. The doctor's bond was set at $9 million.
First and foremost, this fraudulent doctor caused suffering and event death. But the added tragedy is Medicare's inability or unwillingness to prevent fraud. If he hadn't been caught and stopped because of the vigilance of a nurse concerned for the welfare of her patients and a few others, the fraud would likely still be going on.
PROTECT YOURSELF FROM HEALTH INSURANCE SCAMS - 1 views
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The U.S. health care system has changed significantly since the passage of the Affordable Care Act. The federal law introduced many changes to the insurance space and health care market and helped change the way that people shop for health insurance coverage. With the launch of insurance exchanges, new marketplaces were opened up to consumers, but these exchanges also represented a promising opportunity for scammers that are looking to exploit a person's private information. The U.S. Federal Trade Commission recently issued a warning about the growing prevalence of insurance scams, and there are some things that people can do to protect themselves and their information when shopping for insurance coverage. Be Careful About What You Share Online Many insurance scams seek to collect personal information through fraudulent websites. These sites can be designed to look official, but are merely fronts for criminal activity. Many fraudulent sites attempt to show that they represent an insurance or government agency, offering policies at discounted rates, but the policies that these sites offer are not real and exist only to collect information, such as medical records. Beware of Unsolicited Calls Sometimes, scammers prefer to take a more direct approach and will disguise themselves as insurance agents representing a reputable company or exchange. These people often attempt to call consumers and offer inexpensive insurance policies based on the information that they provide. Insurance exchanges do not randomly contact consumers and organizations promoting coverage through exchanges will never ask for personal information to be shared over the phone. Document Everything Keeping records of all salespeople you may come in contact with, as well as the names of their representative companies, could be valuable if your information is ever compromised. Information can be used for or against you, and collecting information from the agents or organizations trying to sell you
Westhill Healthcare Consulting Jakarta fraud prevention review - FTC Warns about fake h... - 2 views
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Tulsa - October marks the start of when many health insurance plans open enrollment.Medicare and Obamacare will also soon begin enrolling for next year's coverage. 2NEWSProblem Solver Jamil Donith has a word of caution before you shop for health insurance online. According to the Federal Trade Commission, health insurance scams are preying on consumers shopping for or comparing health plans online. Scammers use websites or phony non-profit sites that seem to offer discount medical plans. In reality, the sites are set up to get your personal information. Things like your age, occupation, contact information, marital status and whether you have pre-existing medical conditions. The FTC advises: Be stingy with your personal information when you're on the web. When a site asks for your personal information know that data could end up in the wrong hands. A health insurance website might look like the real deal, but many are fronts for criminals wanting to steal your money and personal information. Research a company before giving it your business. Enter the company's name and the "complaints" into an online search engine to see what comes up. And, before giving any personal information ask the company for the details in writing about what you want to buy. If it can't provide the fine prince, that's a big red flag. Finally, check to find out if the plan you want to buy is really insurance. The State Insurance Department can tell you whether the plan is legitimate and whether an insurance provider is licensed to do business in Oklahoma. The Oklahoma Insurance Department website link is www.oid.ok.gov
Health Insurance is one of the most accessible types of insurance. Employees have the advantage of being provided for by their employees with the choice of taking dependents under them. Although there is a provision of health care insurance for most middle class workers and individuals and their families, the rate of insured in health plans are at an uncertain level.
For private and personal insurance providers around the globe, it is not a normal market share. Westhill Insurance Consulting, one of the internet's oldest insurance information sites, compared health care insurance ratio in certain companies in different parts of the globe. Bermuda, one of the world's top ranking countries to provide quality insurance faired better than the status of insured in Westhill's main branch in Massachusetts. In Asia, Singapore is at its highest peak compared to insurance of other providers in developing cities like Hong Kong, Kuala Lumpur, Malaysia and Jakarta, Indonesia.
According to reviews, the United States is lagging behind. If this continues, developing countries depending on the innovations and adaptation from the West can be put into jeopardy. The worldwide issue which causes market fluctuations among private health insurance providers is the rate of medical errors. These errors may have been prevented if legitimate and specialized physicians are being provided for. Instead, most doctors listed under insurance are those consisting general medical practice. For better quality physician and equipment used, an individual has to avail a more expensive premium.
The rising cost of insurance is putting trauma to clients. In response, they take services from fraudulent insurance providers who offers cheaper premium only to discover later that they get scammed.
Such problems require better innovations and technological advancement, a reform on the system or at least, a consideration for the choice of specialist. Innovative solutions involves every aspect of health care-its delivery to consumers, its technology, and its business models. Indeed, a great deal of money has been spent on the search for solutions, a few has been addressed.
The fluctuation in the market poses superior threat to many insurance companies. Many analysts are convinced that the change in the process and the overall method is the solution for the fluctuation. A revamp of the system to integrate technology, new equipment and more qualified physicians can help stabilize the increase of insured clients in private health providers. Unless this problem be controlled and put attention to, fluctuation will continue to dominate the market.