Student Dental Insurance

A college or university student would often receive offers of a student dental insurance from the school through an insurance company. It offers and may cover several dental services. There are also several insurance types of the student insurance for dental care offered.

Students enrolled in private, some public and boarding schools are also given a chance to get the coverage. Dental insurance for students are more affordable compared with individual insurance. They would also allow the student to choose a dental care provider or a health practitioner. They also do not usually assess the student's condition before being awarded with the insurance coverage.

There are several types of dental insurance offered in school. It is important to understand different insurance types offered to understand what is covered.

1. Dental capitation plan. A specific dentist or dental care professional is recommended to the students. Monthly or annual fees have to be paid which can be added to the student's tuition fee. The capitation plan is usually about the preventive aspects of dental care such as cleanings, checkups, fillings and repairing chipped teeth. Schools would usually offer this one since it is very rare that students would require extensive dental work.

2. Dental plan scheme. With an agreement with the school, a private insurance company would be offering insurance to the students. The company could provide students discount when purchasing the insurance.

3. Discount dental plans. They do not require premiums, only a small amount that will give you access to dentists and get dental services for discounted prices. Aside from basic dental work, these discount plans could also cover major dental procedures in times of emergency.

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Overview of Trademark Law

Trademark law gives companies the exclusive right to use a given name or design, called a "mark," for the purpose of identifying the source the of that company's goods or services. Trademark law is an incentive-based system. Because it gives companies the exclusive right to use a mark in connection with certain goods or services, the company can create a brand that is recognizable by the consuming public. That trademark would be associated with and incorporated into every advertisement the company runs for its goods or services. Repetition of those advertisements containing the trademark causes consumers to associate the mark with the goods and, with enough repetition, consumers buy the goods.

A brief, but related, digression. We all know that if you see a product advertised frequently enough, the product will sell. You might even be one of the people who buys the product. The thinking process by which you reached the decision to buy the product is not an intellectual, logical process. It's a function of the way the human mind works. Continually hearing a repeated message makes the message more familiar, more real, and, eventually, more true. As the adage says, "even the boldest lie becomes the truth if you scream it loud enough and long enough." I call this the "Lie = Truth" Adage. Sadly, I frequently encounter the "Lie = Truth" Adage in litigation. I also know of some politicians and terrorist masterminds who are experts at exploiting this fact of human nature.

Back to trademarks. The advertising departments at most companies know the "Lie = Truth" Adage can be very successful in advertising. The cynic would pump his fist in the air yell "Down with the corporations, and power to the people! All the corporations care about is taking our money at all costs!" While we can point to some recent examples that might make it challenging to argue against this viewpoint, as to the overwhelming, vast majority of companies, that view simply cannot be supported.

Trademark law creates very strong incentives for companies to make the highest quality product possible and to advertise their merits and attributes accurately. Aside from the fact that companies invest anywhere from tens of thousands to millions of dollars into their trademark(s), all it takes is one bad product line to tarnish a companies image in the mind of the consumers who buy their products. Both of these factors hit companies where it hurts them most: in the pocketbook. So, while companies clearly have to perform a balancing act of creating a high quality product, keeping costs down, and pulling in as many purchasers as possible, they have very strong incentives to create a quality product that they will associate with their trademark.

To be eligible for any level of trademark protection, a mark must be "distinctive" and not merely "descriptive" of the goods or services. Whether a mark is distinctive and "how" distinctive or strong the mark is can be determined by a sliding scale. Marks can be (1) fanciful; (2) arbitrary; (3) suggestive; (4) descriptive; or (5) generic. Whether a particular mark is protected by trademark law depends on the strength category into which it falls.

A fanciful mark is one that is invented for the sole purpose of being a trademark. For example, EXXON is a fanciful mark. It is a word that does not exist in the English language and was created only for the purpose of identifying the oil and gas company.

An arbitrary mark is typically an existing word that is arbitrarily applied to a product or service that has nothing to do with the word. For example, the mark APPLE as applied to sales of computers.

A suggestive mark is a mark that suggests a quality or characteristic of the goods or services. Suggestive marks require some level of imagination to bridge the connection between the mark and the product. For example, the mark PENGUIN as applied to refrigerators.

A descriptive mark is a word that merely describes a quality or characteristic of a product. Descriptive marks are not entitled to trademark protection unless they have obtained "secondary meaning" under the trademark law. An example of a descriptive mark would be LIGHT to identify a lightweight notebook computer.

A generic mark simply identifies by name a particular product. Generic marks are never entitled to trademark protection. An example of a descriptive mark would be MODEM in connection with modem sales. If trademark protection were allowed in this instance, the company could essentially remove the word "modem" from the English language.

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Trademark - Do I Need One For My Business Name and Logo?

Wondering if a trademark is important to you as a business owner? Let's start with the basics. A trademark is a word, phrase, symbol, or logo that distinguishes and identifies the source of goods of one company or person from another. For example, the name Kraft is trademarked, as is Nike's "swoosh" logo.

The list of what constitutes a trademark is long. A trademark can also be granted to unique packaging such as the shape of Coca-cola's bottle, building designs, color, sound, and even fragrance. Service marks receive the same legal protection, but are used to distinguish services instead of products.

Your business can acquire trade or service marks through the consistent use of a mark. The symbols TM and SM demonstrate the owner treats the mark as a trademark or service mark. There is no requirement to federally register at the trademark office. You are still protected under intellectual property laws. However, if another party uses your mark it can be more difficult to prove your ownership.

To register online with the United States Patent and Trademark Office (USPTO), go to www.uspto.gov There is a registration fee for each name, logo, and slogan. Federal registration ensures another party is not already using your mark. A registered trademark gives you exclusive rights to use a mark with your particular goods or services. The USPTO can only register trademarks for marks that are used across state lines. A website customers can access in other areas can satisfy this requirement. Otherwise, you will only be able to apply for a state trademark.

Only a mark registered and approved by the USPTO can use the ® symbol. Since the application process can take many months to complete, use the TM or SM symbol in the meantime to establish your intention to use the mark as a trademark. Make sure you keep records as to when your mark was first used in commerce and regulate the use of your mark in the marketplace.

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Emergency Medicine Physician Billing Compliance - Medicare, PPACA, RACs, HITECHs

Since Medicare Audits began they have primarily been used as information gathering. However with the passing of the Tax Relief and Health Care Act of 2006, which made recovery audit contractors extension into all 50 states mandatory by 2010, and adding the passage of PPACA and the effects of HITECH, audits are coming from all directions. More importantly they are being used to recover over-payments and possibly with penalties. What do we do as ED physicians?

Look for physicians with outlying data. Check your standard deviations for over performing E&M levels, critical care and procedures. If you find outliers, then prepare a document that substantiates why they are outliers and/or identifies what the physician(s) is doing wrong, document education and follow up that they have corrected the issues. Not only can you do this with over performers but also under performers to improve charge capture. In my experience, for every over performer, there are three under performers. In effect, a compliance program that also focuses on charge capture will, in the final analysis, have a positive impact on revenue.

Determine why they are outliers. There are a number of legitimate reasons that a particular physician may higher significantly higher level 5s, critical care time etc... Some of the causes to look at are: 1. Triage acuity pick ups 2. Shifts worked 3. Admission percentage 4. How long out of residency 5. Percent of charts with a well thought out differential 6. number of hours worked with mid level coverage versus the group average

Perform periodic education for all physicians and mid-level providers. At least annually present to your group some form of documentation training. Document this training and have everyone sign off on completion of the training. For example, have an annual dinner/company retreat and include a ~3 hour presentation on documentation training/reminders, group and individual performance measures and annual updates. Just about everyone looks forward to this as sort of a group retreat and open forum on these issues.

Provide a documentation guide. Whether your ED physicians use EMR, dictation, templates or another form of documentation, a readily available reference is vital to compliantly capturing all of your services in the ED. We perform so many different procedures and services in the ER (everything from cerumenectomy to observation) that many physicians not only find themselves not knowing exactly how to document them, but sometime physicians do not know what they don't know so that either they fail to document services rendered or do so in a non compliant manner. We have found that having a comprehensive guide to documenting specific to the practice and that is group specific and done in consultation with your coders is vital to charge capture and compliance. Every coding department or system will have slight variations on exactly what they want to see to capture a service (for example, for a splint procedure, do that want to see documented that the physician was present when the splint was applied or just examined afterwards and what are the best words to communicate etc...)

Here is an example from a section of one of our documentation guides:

Observation Care:

Increases RVUs by ~one RVU on each case, this is significant. Usually 2-6% of ED patients are eligible.When is it used? Three requirements: 1. Meet the Time requirement 2. Admission is a possibility 3. An Order for Observation is on the chart

Time is being used as diagnostic tool Either 8 hours of medically necessary observation or any amount of time that spans one calendar day (11pm on one day to 1am meets the requirement)*

Admission is a possibility

Order for Observation is on chart

What is required?

A timed order for observation on the ER face sheet

A dictated note in a separate paragraph which contains:

The time and date that the observation started and stopped

The medical necessity of the observation (i.e. an intoxicated patient who had a fall in order to rule out serious injury or an asthmatic patient in order to decide to admit or not)

The results, reassessment and disposition of the observation.

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How Under-Coding Affects the Financial Well-Being of Your Medical Practice

Most physicians are concerned with using the proper coding parameters when submitting claims to insurance providers, and with good reason. It is not uncommon, however, for a physician to be unfamiliar with the proper coding techniques and guidelines for office visits. Due to this lack of understanding, these physicians can only guess which code should be used, rather than using the code that is actually meant for the treatment provided.

In some cases, the above approach does work. In most instances, however, improper coding creates serious issues with a practice's records and documentation. By taking a "hit or miss" approach to coding and billing procedures, these physicians are losing money that they are rightfully entitled to.

When it comes to billing, your practice has three options. You can either up-code, down-code or under-code to varying degrees. The term "under-coding" refers to a reduction of coding for a variety of reasons. For purposes of this article, we will address office visit codes known as Evaluation and Management codes and how you can ensure that you are using them properly.

Throwing Money Away

Some doctors bill all of their office visits at a lower level code, such as 99212. These doctors hope that by doing this, they will be able to alleviate billing complications. Unfortunately, this approach to billing does more harm than good to the financial well-being of your practice. First and foremost, when you generalize your coding like this you are losing out on a lot of revenue - usually to the tune of about $100,000 each year. However, this is not the only problem that this billing technique presents. If you use a single, lower-level code for all of your office billing, you are going to run into problems if you face an audit. In fact, under-coding can actually lead to an audit due to the overuse of the code you are using for your office visits.

Documenting Medical Necessity

Properly documenting your patients' office visits is paramount to proper billing. The criteria for being paid for an office visit is Medical Necessity. If you have documented the Medical Necessity of the services you provide, you should have no problem being paid for the visit. If you are meeting the proper criterion for higher billing codes and you did the work, you have every right to be paid for it. For example, if you treated a problem and have the criterion present to bill for 99214, why would you bill for 99212?

Avoiding What You Don't Understand

Many doctors avoid coding properly due to a lack of understanding. If you want to ensure that you generate as much revenue as possible for your practice, you need to code correctly. For example, if you are treating a diabetic that is controlled, you should use 250.00. However, if you are treating an uncontrolled diabetic, you should use code 250.xx or one of the other codes with a fifth digit. The more accurate you are in your coding, the more revenue you will be able to generate for your practice.

While under-coding may seem simpler in the short-term, in the long term it will result in being paid less for what you do. As more practices face cutbacks and reimbursement reductions, it is crucial to maximize your revenue whenever possible. You owe it to yourself and your practice to capture as much revenue as possible. This means taking the time to learn the proper coding techniques that will put as much money into your practice as possible.

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Running a Car Wash Fundraiser Using a Pressure Washer

If you are considering on doing a car wash fundraiser to help raise money for a small non-profit organization, may I suggest that you use a Pressure Washer to wash all the cars? Why? Well because you can wash the cars faster, save water and do a better job.

You see pressure washers put out between 1,000 and 3,000 pounds per square inch and that results in a significant amount of cleaning power. In fact, much of the dirt will be blown right off the cars. As long as you keep the tip away from the car by 12 to 18 inches you will do fine and you can get closer in if you are doing the rims.

Most small pressure washers put out about 1.2 to 4.5 gallons per minute. A garden hose might put out 6.5 to 10 gallons per minute and that is a significant difference. This means less water is used and the pressure washers have a spring loaded shut off nozzle on the trigger gun too. It is everyone's responsibility to save water these days and we must all pitch in.

Wasting water at a car wash fundraiser doing it the "Wrong Way" does not teach the kids the responsibility of the value of water. Of course we must not forget the importance of quality, because the customers are paying you good money to have their cars washed and using a pressure washer blows the grit off prior to soaping and this will prevent scratches.

There is really no reason not to use a pressure washer at a car wash fundraiser and some parent in your group has a pressure washer for home use or that they use in their small business. So please consider this. Here is a complete free online book to help you: http://www.carwashguys.com/fundraisers/LAschools.html

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