Avoiding the Hidden Dangers of Compliance

I come to you a day early this week at the beginnings of a vacation.

My one-week break (save for this space) started with an interesting occurrence in my neighborhood. As my family and I were sitting down to dinner last night, we saw flashing lights coming in from our front window. These lights were the beginnings of what turned out to be a gathering of four fire engines, one fire SUV (the chief drives stag), two police cars and – one interesting addition to the vehicular melee – an animal control van. It seems that a house across the street from my own in Milwaukee was discovered to contain a bevy of unattended exotic wild animals, including 5 anacondas ranging in length from 20 to 30 feet.

I am very much a man with concrete in my soul. Due to a contented life of urbanization, annoying allergies and a pathological fear of bugs, I’ve always preferred city life. Say the word “camping” to me and I instantly think of a room on the bottom floor of the hotel. Early yesterday, the list of pluses for city living also included the words “….and no tropical snakes!” at the bottom of it. I guess we can scratch that off now. I used to get a good laugh at the local news’ “man-in-the-street” interviews with stories like this. It’s not so rib-tickling when those sudden TV personalities are your neighbors talking about another person in your neighborhood who decided on his own to start an unsupervised Brazilian zoo in the middle of your block.

Yesterday’s improvised neighborhood reptile round-up was yet another reminder that the world is full of hidden dangers. As my mind races at the thought of what happens the next time I stand in the shower with the water running thanks to my neighbor’s keen interest in herpetology, I also spare a thought to the hidden dangers in the world of medical billing, specifically as it relates to compliance and government audits.

I try to explain it to the laymen in the following fashion: every bit of information that goes out on a typical health claim to an insurance carrier has the potential not only for denial, but for larger compliance problems down the road. Try this exercise: find a blank CMS-1500 form some time and start from Box 1 in the upper left hand corner and work your way down all the way to Box 33b in the lower right. In each box, identify a reason for that box as to why a claim would be denied by an insurance company. Depending on the payer, the reason for the claim, the services being claimed, and a host of other factors, an experienced biller or coder should be able to identify errors that could occur with at least 20 fields that could potentially lead to a claim denial. These could be as simple as “Date of birth entered incorrectly” to “CLIA waiver number not included in Box 23 for a governmental payer”

The compliance view doesn’t stop there. The last question that should be asked before a claim is prepared for billing should always be “Do the services reported on this claim best represent what is documented in the patient’s medical record?”. If there is any question whatsoever of the answer being a firm “Yes!”, It’s best to give the claim a second look.

With some regulatory teeth provided by the Patient Protection and Affordable Care Act, the compliance landscape for providers of all specialties is about to morph into something more intense than we ever could have imagined just 10 years ago. Five years from today, more sets of eyes will be looking at medical claims than ever before, thanks to an alphabet soup of regulatory agencies both currently in existence and still on the drawing board. Now is more than past the time to internalize the idea that the contents of every claim, much like the house full of serpents down the block, is something that should be taken very seriously.

The Benefits Of Investing In Repossessed Home Properties

Bank repossessed home investing offers many advantages and benefits to people on the lookout for a piece of real estate to invest in. If you are not familiar with bank repossessed home investing, you may need to study and look deeply into their benefits before you move on with your search for potential investments.

A major benefit that bank repossessed home properties offer to investors may come in the amount of money that can be saved in purchasing these properties. It is common for investors to discover repossessed home properties that are up to 50 percent off its regular market value.

Even if you cannot find repossessed homes that can offer you such heavy discounts, no doubt that you will be able to find a repossessed property or two with at least 10 percent off of the prevailing real estate market value.

Another great advantage of bank repossessed home investing is that the buyer is always in the driver’s seat of every real estate deal. The main reason for this is because the bank would be more than happy to unload the house as soon as possible in order to recover their losses and start to make money again. At bank repossessed home investing, the buyer may have a better bargaining power and may be more than likely to get a better deal than with buying other types of real estate properties.

The way bank repossessed home investing works is so simple. You buy available bank repossessed homes for below its market value, make them look attractive if there is a need and sell them afterwards at or above the prevailing market value for such properties. The difference in your buying and selling price and other expenses becomes your profit.

You can greatly benefit from bank repossessed home investing if you are planning to set up an additional stream of income. Another alternative available for you is that instead of selling your newly purchased properties, you can rent them out for a continuous income stream.

This will assure you that you will be getting some income every month of the year. This can really appeal to a lot of people who are looking forward to retiring, but who want to ensure that they will be financially secure in their retirement.

Buying Or Selling a Medical Business

Medical businesses are very popular with buyers these days, the media and general word on the street tells buyers that the medical industry is the industry to be in.

Buyers are interested in any business that is medical related and buyers are even more interested if the medical business does not require the owner to be a doctor or have a medical degree. Examples of Medical businesses where no formal degree or doctorate is necessary to own include medical equipment businesses, Magnetic Resonance Imaging (MRI) businesses, medical testing businesses, nurse staffing businesses, home care businesses, disability assistance businesses, urgent care clinics, medical scooter businesses, Assisted Living Facilities, Hearing Aid businesses, medical transport businesses, medical rentals, medical supply manufacturing and distribution and many more.

All of them resonate with buyers who are looking for medical businesses, but sellers will still need to address a buyer’s requirements for purchase.

These requirements will include the financials of the corporation, a decent location, qualified employees and their willingness to stay with the new owner especially if the business requires someone in their trade to operate, the type of owner experience necessary, the regulations they must follow, the type of insurances needed and what the owner’s day to day role in the operation will be.

One primary concern for buyers and sellers will be obtaining financing because some banks will require prior experience from a buyer before they grant them financing even if that additional experience is not necessary to own the business. The banks want to feel secure about who they are financing.

Medical businesses where the primary business stems from doctor/ patient consultations and sessions are also in demand. These businesses include businesses such as dental offices, orthodontist practices, eye doctors, general practitioner practices, physical therapist offices, chiropractic offices, and surgical practices.

These businesses don’t always sell for the highest multiples if they are smaller operations, but current doctors and professionals seek out practicing offices to buy when they are relocating to other areas or adding on to their existing practice. Buyers will valuate these businesses for sale based on the financials, locations, list of clients, and they will many times require extended training and transitioning time from the current owner in order to make the deal work.

This is especially important if the patients are consistent and ongoing because they will want to feel more at ease with the new owner of the business. This means that these transitions really require that the buyer and seller can get along and maintain a good working relationship.

Lee Ossin is a Licensed Broker Associate and owner of Crowne Atlantic Properties, LLC. Mr. Ossin specializes in the sale of landscape businesses, beauty salons, asset sales, medical businesses, restaurants, and manufacturing companies, as well as business sales dealing in Foreign Visas and SBA loans. He is also a member of the Business Brokers of Florida and the Orlando Regional Realtors Association.