Articles on Insurance Matters:

More on Lost Wages

Some time ago I wrote an article for the absolutely sensational ARTICLE CITY regarding the handling of your personal injury claim regarding how one should proceed to collect for their LOST WAGES.

Since then I’ve been asked so many questions about that subject matter I've decided to go into even greater depth regarding this highly complicated subject matter. So, here we go:

GENERALLY SPEAKING: If you're claiming five weeks of lost wages, and your Medical Record shows you were discharged in three, you're in deep “stuff“! You're chances of collecting for those additional two weeks is probably minus-zip.

No matter who says what you must make sure that the Final Medical Report, is handed to you - - only you - - nobody else !

Why ? So you'll have a chance to read it before you hand it to Adjuster Henry Hard-Nose employed by Rock Solid Insurance Corporation.

In the event that the report doesn't have everything in it that it should (which I’ve expressed in detail below) you have every right to return it to Medical Doctor or Chiropractor who wrote it and ask that it be rewritten in clear language, detailing and explaining the pain, discomfort and suffering they observed you experienced.

It if isn’t executed correctly Rock Solid Insurance and Hard-Nose will absolutely swoon with joy because the value of your claim will have done a nose dive into the nearest sewer. Why? Because your Final Medical Report has been executed in a sloppy manner and they know, in their secret heart’s, that even though you went through a tremendous period of “Pain and Suffering” if it’s not adequately spelled out your claim suddenly has much less value !

Assuming your Final Medical Report has been written accurately that's money in the bank! But, far too often they're dashed off in haste by a "Busy-Busy" Attending Physician or Chiropractor. Don't let that happen to you because, if it does, that hot, slick tongue you feel on you're lips, and sliding into your throat, is the result of the kiss of death that’s being given to you moments before your seduction.

SICK LEAVE OR VACATION TIME:

If you had to take sick leave, or vacation time, during the time you missed from work, it's absolutely part of your claim. Never forget you would have been entitled to use that sick leave and/or vacation time, - - later on down the road - - when you needed or wanted it.

NEVER FORGET: If you're forced to take either (because of a motor vehicle accident) it's the same as losing the pay itself. Don't let Hard-Nose attempt to pull his usual "Con Job" and tell you any differently!

LOSS OF PAY VS. TRIPS TO YOUR ATTENDING PHYSICIAN:

If your Lost Wage Document, which was executed by the company you work for, states that you didn’t work during the same period you were being treated by your attending physician, that’s all the proof you need to be compensated for your “lost earnings”.

HOWEVER: If your doctor didn’t treat you any longer after a certain date (even though stated and detailed in your Lost Wage Document) than your chances of recovery for your lost wages, after that particular date, are minus zip!

BACK TO WORK BUT STILL TREATING:

If you’ve returned to work, but you’re still being treated by your attending physician, that Lost Wage Document should clearly state the date and hours you missed when you had to leave work and make that day trip to see your doctor and/or receive treatment.

BACK TO WORK HOWEVER NOT BACK AT YOUR USUAL, NORMAL, ROUTINE ASSIGNMENT:

During my almost 40 years in the business of insurance claims I often ran into a situation where the claimant insisted they were unable to return to their old job and this caused them to have a lesser income. However, there were many times when the only proof of this was their verbal contention and that was unacceptable .

That’s why it’s so important (should this apply to you and your work/income situation) that this is clearly spelled out , by the company where you’re employed, in their Lost Wage Report. An official notation on the bottom of the document, stating this to be true, can save you a lot of grief, and a earn you a ton of money!

LOSS OF OVERTIME PAY:

The overtime you lost is a legit claim. Get a letter from your employer spelling out the amount of money you lost in overtime. They can do this by taking a look at last years income, during the same period you were laid up, then figuring out the overtime income you lost, for that identical space in time. Once this has been determined THIS TOO should written into your Lost Wage Report.

ONE LAST WARNING

The inside claims people at Rock Solid Insurance Corporation and adjusters like Henry Hard-Nose are buried alive with hundreds (sometimes thousands!) of claimants who are going through a great deal of "Pain and Suffering", and they just don’t have the time to properly consider the seriousness of what you‘ve had to deal with, no matter how legitimate it may be.

You ask, "How can Dan be so sure about that" ? The answer is very simple, "Because I've been there and done that".

HOWEVER: If you follow what I've laid out above, you'll stay ahead of them, win the ball game and be awarded all the lost wage damage's that are owed to you - - PLUS increase that additional payment for your "Pain and Suffering" !

DISCLAIMER: The only purpose of this article MORE ON LOST WAGES is to help people understand the motor vehicle accident claim process. Neither Dan Baldyga, Peter Go nor ARTICLE CITY make any guarantee of any kind whatsoever; NOR do they purport to engage in rendering any professional or legal service, to substitute for a lawyer, an insurance adjuster, or claims consultant, or the like. Where such professional help is desired it is the INDIVIDUALS RESPONSIBILITY to obtain said services.

All of the information necessary for you to deal with and handle the above issues are spelled out within the contents of Dan Baldyga's latest book Auto Accident Personal Injury Insurance Claim (How To Evaluate and Settle Your Loss) be found on the internet at http://www.caraccidentclaims.com or http://www.autoaccidentclaims.com. This book also contains BASE (The Baldyga Auto Accident Settlement Evaluation Formula). THE BASE FORMULA will tell you exactly how many dollars the "Pain and Suffering" you endured because of your accident - - are worth!

Copyright 2004 by Daniel G. Baldyga All Rights Reserved

Dan Baldyga
15 Mar 2007

Dan Baldyga is now retired and spends his time writing articles to assist those who are involved in motor vehicle accident claims so they won't be taken advantage of: dbpaw@comcast.net .

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Medical Claims

Medical Billings and Claims: During the recent few years it has been noticed that the sector of various medical treatments have changed tremendously. The warren of complex claim forms as well as insurance policy procedures all over the world besieges even the doctors. The doctors really need time focusing on their patients, but due to the complex and puzzling billing processes from the private and the government managed insurance companies, HMOs and PPOs, these doctors every now and then are anxious about getting their payments for all the services or the treatment provided by them to the patient. Perhaps, at this juncture only the doctors greatly bank upon the services rendered by the private parties in this sector. Such Medical Billing service providers usually work from home and fetch a sizable amount of remuneration by bridging the smooth links.

These service providers hardly require any specialized training or experience to start their own set-up at the most negligible cost. All they genuinely need is a computer system, printer, electronic modem and just an authentic claim processing software program installed in the computer systems. The size and scopes in this service-oriented business is tremendous. You have the option of specializing in some specific segment such as: chiropractic, pediatric or even dentistry for instance. You can also determine the number of health care professionals or doctors you sincerely want to work with as your clients.

Electronic Medical Claim Billing: Electronic Medical Billing could well be defined as the billing procedure that is merely paperless. After feeding specific data entries concerned with the particular patient’s treatment, in to the computer system for preparing the bill, it is printed out and submitted to the concerned party by the doctor of that clinic. These types of Electronic Medical Claim Bills incorporate all the necessary detailed information about the insurance formalities for its easy and quick settlement of payments. Such a detailed billing is very essential in getting the doctor paid for his treatment charges by the concerned medical insurance providers.

Medical Claims Processing: The Medical Claims Processing is highly required to be streamlined in terms of its technicalities for easy and quick reimbursement of the payment. If the following points are taken care of, it will be easier for anyone to work on the same: tracking and managing the claims easily with the particular Claims Center, get the quickest reimbursements through eClaims and eRemittances, having the constant access to the most current ICD9 and CPT coding with the internet online codebook, and utilize the charge entry HCFA or UB92 claims forms. There are certain service providing companies like The AdvancedMD Claims Center that truly provides the extremely suitable way for tracking the claims right from its posting stage to the payments. The outstanding claims or the delayed collections always add the managing tensions on the hospitals or the doctor’s practice. This is more because on one side the insurance companies very often reject the claims or deny payments whereas on the other side, the Federal regulatory are getting more strict in the United States.

Medical Claims Management: The Medical Claims Management invites a lot of patience and alertness, failing which the doctor or the medical service provider professional may lose his claim even after extending all the possible treatment to his clients. Improper or unplanned management of medicals claims may easily make the great deficit or shortfall in your financial budgets. One should seriously consider his cost control program for proactively controlling the costs of patient health care. Before submitting your Medical Claims, simply checking some vital points such as: checking the errors of coding and billing, sending the explanation of benefits, for making the claim accurate – pre-adjudicate it, properly filing the process claim with the insurance company, providing all the electronic eligibility details and claim status, and receiving the refused claims and re-adjudicate them as suggested for getting them approved, may save your time and energy to a great extent. To summarize, try and use the ideal processing software to avert refusals or rejections of your claims at comparatively much lesser efforts.

Medical Claims Software: Medical Claims Software could be defined as the blessings for medical professionals as it indeed saves both time and energy. The accuracy levels of the claim also elevates to a remarkable stage. Such software helps you prepare or frame your Medical Claims almost in the requisite order minimizing the refusal or denial chances to zero. Moreover, using this software is really easy and enjoyable too. All you need to do is simply sit across your computer system and go on entering the directed information for preparing the insurance claims. Medical Claims Management software tracks claim management, patient billing, insurance and scheduling in the single package.

Medical Electronic Claims: Due to the advanced technologies nowadays, submitting all the claims electronically both to the commercial and government with full online audits and edits with the help of the medical billing software installed in your computer systems. Thus sending the Medical Claims Electronically truly has some significant benefits, such as: the claim acceptance chances rises as much as 30%, the payment time is reduced to as much as 50% and the most claim services have been priced less than the cost of supplies required for submitting claims on papers. This is why most of the insurance carriers motivate the medical professionals for using the Medical Electronic Claims system so far possible. The cost of processing the electronic claim is comparatively lesser than the claims submitted on the papers.

Audit Medical Claims: The periodical Audit of Medical Claims is advisable to avoid loss of both time and energy. Thorough auditing of all the claims will minimize the ratio of the denial or refusal and the reimbursement of payments will also be faster.

Medical Claims Payment: The insurer may pay the claim amount based on the report of non-wage loss injury without payments being interpreted as an acceptance of liability. Within 10 days of making payment, the insurer shall notify the worker of the payment. Based on the written request by the worker for payment of insurance benefits, the insurer will investigate the claim for ascertaining the liability for injury.

Medical Claims Processor: Amendments in healthcare management and delivery have raised the demand for professionals trained for processing the claim payments submitted to the medical insurance carriers by different healthcare professionals.

Nisha G.
19 Mar 2007

The author is webmaster of http://www.medibil.com which is an information portal. medibil.com offers quality information on topics like medical billing, medical coding, medical claims, medical transcription and Insurance.