Monday, November 30, 2015

Momentum Monday - Why Not with Sean Callagy #27

#MomentumMonday | Why Not?!

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You can see all of our WHY NOT – HUDDLE videos by clicking here and subscribing! If you have questions about any of the content you see or to have your questions answered on an upcoming show by Sean, please email your questions directly to him by clicking here.

The Daily Why Not Huddle is for you if you want to exponentially increase your money, time, or fulfillment. The Why Not Huddle with business coaching expert, successful entrepreneur, and attorney Sean Callagy provide the essential daily ingredients for you to create and achieve your destiny.

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Momentum Monday - Why Not with Sean Callagy #27

Friday, November 27, 2015

Importance of Emotional Rapport—Part II | Callagy Law

A blog post by Christine Piccirillo from the Callagy Law Liaison Team

Click Here for The Importance of Emotional Rapport – Part I

The following article was written by Callagy Law’s Legal Team, and will focus on many common questions and concerns surrounding new developments, legal matters, and other procedures within the field of healthcare law Medical Revenue Recovery, PIP, Workers Compensation, and Commercial Insurance. Our mission is to answer any questions and give knowledge to many different aspects of these matters.

I would like to start the discussion of emotional rapport with a statement as to what it is not. It is not phony; it is not a trick; it is not a tactic; it is not manipulative. Emotional rapport is engaging with people on a personal level so that they appreciate you and you appreciate them beyond your immediate common interest. It is an incredibly important aspect of any relationship, whether personal or professional. When you connect with people in this way you build and develop deeper, more meaningful relationships, which tend to last much longer than other less-profound relationships.

I am a client liaison for Callagy Law, meaning my main function is interacting with our medical provider clients to assist them with recovering revenue from insurance carriers. This effort takes place across all categories of medical claims—PIP (Personal Injury Protection) / No Fault, Worker’s Compensation (WC), and Commercial Insurance (CI)—and across all types of medical providers—from hospitals to surgeons, from surgery centers to physical therapists. My relationships with our clients must be meaningful and profound for the firm to be successful at obtaining for those clients as much money as possible, as quickly as possible.

Click Here for The Importance of Emotional Rapport – Part I

Most often, emotional rapport does not just happen—it is built. “Love at first sight” does happen, but it is a rare exception. Most meaningful relationships are built over time and are nurtured because they are important. This can happen by having common interests, or sharing beliefs, values, and goals. You need not agree on things, but you need to interact in ways where you communicate these things and gain an understanding and appreciation of the other person’s views, feelings, story—and everyone has an interesting story. We are all stars in the movie of our lives, and all of them are fascinating when understood from the perspective of the star. Some people say that “when people are like each other they tend to like each other.” While this is probably true, it does not have to be the case. You can build emotional rapport with virtually anyone, because we are all human, and all humans face the same struggles for financial security, for relevance, for validation.

Building rapport builds a relationship on an emotional level, which then allows us to gain trust and understanding of and from our clients. This allows us to be seen as a valuable asset, which we are and will be. I want to be more for my clients than simply their client liaison; I want to be a trusted advisor to my clients.

We hope you have found this information helpful and interesting. Please reach out to us here with any questions or comments regarding healthcare legal matters, or if you are a medical provider that has questions regarding Medical Revenue Recovery, PIP, Workers Compensation, and Commercial Insurance.. Feel free to search us on Facebook, Twitter or LinkedIn! Additionally you can subscribe to our daily videos on YouTube.

Click Here for The Importance of Emotional Rapport – Part I

Learn More About Callagy Law Here:

Importance of Emotional Rapport—Part II | Callagy Law

New AND FREE to Share - Why Not with Sean Callagy #26

#FunFriday Why Not?!

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New AND FREE to Share - Why Not with Sean Callagy #26

Thursday, November 26, 2015

Freedom of Speech vs. Freedom To Not Be Offended | Callagy Law

OFFENSIVE” REDSKINS GO ON THE OFFENSIVE

After searching various sources, we have found many people have questions when it comes to legal matters. The Callagy Law team has written the following blog post to help you better understand the inner workings of the legal system.

What’s in a name? If you are the Washington Redskins – a lot.

The Redskins’ parent company, Pro-Football, Inc., recently filed its opening brief in an appeal to the Fourth Circuit challenging the Eastern District of Virginia’s decision granting summary judgment in favor of five Native Americans who successfully petitioned the Patent and Trademark Office to cancel the Redskins’ trademark.

The filing is the latest in the ongoing saga over the perceived offensiveness of the NFL team’s trademarked name, and it puts into sharp focus how cultural trends, freedom of speech, and commercial law overlap.

The district court held that Section 2(a) of the Lanham Act, which governs trademarks, does not implicate the First Amendment because the cancellation of a trademark does not burden, restrict, or prohibit speech. It also held that registration of a trademark is “government speech,” which is therefore exempt from First Amendment protection. Importantly, the district court further held that the Redskins’ name was “disparaging to a substantial composite” of Native Americans when it was first registered in 1967, as the precedent concerning Section 2(a) of the Lanham Act requires the analysis to focus on the time of registration, not the time of cancellation.

In its brief, Pro-Football, Inc. noted – tongue in cheek – that if trademarks are government speech, then the government has endorsed countless racist, misogynistic, and otherwise grossly offensive speech, including “Take Yo Panties Off” clothing, and others too vulgar to repeat here. But the gravamen of the argument is more metaphysical than playful: the subjective concept of “disparagement” and the vagueness of the term “substantial composite” subjects trademark holders to arbitrary cancellation of often-substantially lucrative legal protection. (Pro-Football, Inc. estimated that the Redskins’ trademark alone was worth $214 million.) According to Pro-Football, Inc., the district court’s decision was an “invitation to 300 million Americans to challenge any mark they disfavor” which would “guarantee[] chaos and unpredictability.”

In a post-Citizens United world the legal definition of speech itself has become controversial. Commercial speech—i.e., any speech intended to convince the listener to enter into a commercial transaction—has generally been treated by the Supreme Court as less valuable than, say, political or artistic speech. This case is particularly important because it pits the growing political and cultural trend of so-called political correctness against a giant of capitalism. It speaks to the law’s role as both the reflection and driver of cultural trends as well as its role as the arbiter of millions of disparate interests, viewpoints, and opinions. It‘s a case that will have far-reaching repercussions for any heavily invested trademark holder.

And it’s all about a name.

Sean Callagy, the owner and President of Callagy Law is an attorney, business coach, public speaker, and entrepreneur; is dedicated to the personal and business growth. Please reach out to us here with any questions or comments regarding personal or business matters. We will to continue to provide daily updates with helpful information on our website and social media. Please feel free to contact Callagy Law at anytime. Feel free to connect with us on Facebook, Twitter or LinkedIn! Additionally you can subscribe to our daily videos on YouTube by clicking here.

Learn More About Callagy Law Here:

Freedom of Speech vs. Freedom To Not Be Offended | Callagy Law

New AND FREE to Share - Why Not with Sean Callagy #25

#HappyThanksgiving

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New AND FREE to Share - Why Not with Sean Callagy #25

Wednesday, November 25, 2015

A History of Workers’ Compensation: Part I

Workers’ Compensation, Defenses and the History Behind It All

The history of workers’ compensation law has its roots in Sumaria, circa 2050 B.C., where the laws of King Ur-Nammu compensated workers for injuries to specific body parts. Many ancient civilizations such as the Babylonians, Greeks, Romans, Arabs and Chinese followed suit and also provided scheduled compensation for worker injuries. Under these systems, compensation was commensurate to the injured body part.

During the middle ages, the ancient systems of workers compensation gave way to the whim of the feudal lord. Payment for injury was left entirely to the discretion of the noble class. The development of the common law system in the 17^th century provided workers with some reprieve, however, they were still subject to three anti-worker defenses: 1) Assumption of Risk; 2) Fellow Servant Rule and; 3) contributory negligence.

Under the “assumption of the risk” defense, employees assumed the risks inherit in their jobs. Although, employers were required to provide industry standard safety measures, worker safety was an afterthought in many industries prior to the 20^th century. Furthermore, many workers were forced to sign “worker’s right to die” contracts as a condition of employment. These contracts forfeited the worker’s right to sue for injury. The “fellow servant rule” held employers not liable if the injury was caused in part by the negligence of another worker. Under the contributory negligence defense, an employee was not liable if the injury was caused by any negligent act on the part of the injured worker. These defenses were known as the “unholy trinity” and made recovery practically impossible. Additionally, a worker’s only recourse was through an expensive court system that was out of reach for the common man.

The framework of the modern worker’s compensation system does not come about until the late 19^th century from an unexpected source. Otto von Bismarck was chancellor of the Prussian empire during the latter half of the 19^th century. His political policies led to the persecution of opposition parties such as the Marxists and Socialists. However, in order to prevent rebellion, Bismarck adopted some socialist programs that expanded protection for workers. In 1884, he created Workers’ Accident Insurance. An important advancement in Bismarck’s reform was that the system was the exclusive remedy for workers’ compensation matters.

By the end of the century, other European nations adopted the Prussian workers’ compensation model. In the 1880s, the United Kingdom abolished the unholy trinity of defenses. However, “right to die” contract still prevented significant progress. It was not until 1894 that the United Kingdom adopted the Prussian no fault system. Change in the United States was still a decade away.

The Team at Callagy Law hopes the information in this article was helpful in either your personal or professional life. The legal world pertains to all walks of life and more specifically, various types of healthcare providers. Callagy Law, is a multidisciplinary law firm, headquartered in Paramus, NJ owned and operated by Sean Callagy. We are committed to providing legal representation and advice to our clients at additional law offices located across the United States. Please note that the information posted here should not be used as a legal argument of defense. If you find yourself needing legal advice pertaining to your unique situation, you can contact us at here. Feel free to search us on Facebook, Twitter or LinkedIn! Additionally you can subscribe to our daily videos on YouTube.

Learn More About Callagy Law Here:

A History of Workers’ Compensation: Part I

Law and Entrepreneurship TV - Episode #25, #‎AskSeanCallagy‬

Exponential Growth and the Trajectory of Your Success

Callagy Law and Entrepreneurship Library – TV is an original series from Sean Callagy, President and Founder of Callagy Law; to help the general public with every day legal questions and information. For more information about Sean Callagy, Callagy Law, or any questions you have, please email scallagy@callagylaw.com

If you’d like to have your legal questions answered on the show, email Sean: scallagy@callagylaw.com

See more here: www.callagylaw.com/blog

In this article / video, Sean Callagy will focus on topics to help people better their legal knowledge of vital information. Clients often come to Sean Callagy’s team with questions about their businesses, ranging from contracts, disputes, and other common legal issues in the business and entrepreneurial world. Our mission is to answer any legal questions and provide information to anyone who may need it. If you have questions about any of the content you see or to have your questions answered on an upcoming show by Sean, please email your questions directly to him by clicking here.

Law and Entrepreneurship TV - Episode #25, #‎AskSeanCallagy‬

Why Not Have Your Happiest Thanksgiving? | Sean Callagy

Why Not Huddle with Sean Callagy – November 25, 2015 (#WhyWednesday)

Dear Kindred Spirit:

Happy Thanksgiving to you and your loved ones. A few thoughts for this Thanksgiving from my heart.

I am filled with gratitude for all of the support that you’ve given during this first month of Why Not.

I am incredibly thankful for all of our clients for Callagy Law that have entrusted us with helping them through their legal challenges. From our doctors, to our hospitals, surgical centers, other healthcare entities to our business owners and entrepreneurs to our wonderful people that have entrusted us with legal challenges, with all my heart, thank you.

For some of you, I’ve had the privilege of working very closely with you on your life’s goals and daily ongoing challenges, for this level of relationship and trust, I am eternally grateful.

I am also so thankful to all of our team members at Callagy Law. Everyone has contributed in some way to helping our clients, and one another grow and achieve so many successes. For those that truly want to play a huge game, it is only the beginning of the beginning. Thank you to everyone.

To the FAA and GGG worlds, thank you to everyone for an amazing 2015 watching our children grow and succeed beyond our wildest expectations. The future is bright beyond imagination.

To my family, friends and loved ones, thank you for all of your amazing support. 2015 has been one of the most dynamic and exciting years of my life, and maybe, one of the most challenging. My vision has changed to the point where I no longer drive. Watching television, which I don’t do often anyway, has become very challenging. This could easily have been one of the worst years of my life. Instead, because of all the love and support I’ve received, I am in a place of amazing gratitude, peace, joy, excitement and acceleration in my life and my business.

To all of you, in addition to my gratitude, you have my wishes for a Thanksgiving of love, joy, healing, forgiveness, inspiration, truth, justice, victory, triumph, rejuvenation, “living at cause“, “zone action“, attainment, connection, validation, fulfillment, laughter, gratitude, health, power, energy, vitality, exhilaration, passion, and any other positive feeling imaginable.

Have an amazing Thanksgiving!

In Your Service,

Sean Callagy

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Why Not Have Your Happiest Thanksgiving? | Sean Callagy

Tuesday, November 24, 2015

New AND FREE to Share - Why Not with Sean Callagy #23

#TimeManagementTuesday!

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New AND FREE to Share - Why Not with Sean Callagy #23

The PIP Pre-Certification Process | Callagy Law

A blog post by Stacey Hoskins, Callagy Law Paralegal

After searching various sources, we have found many people have questions when it comes to Medical Revenue Recovery, PIP, Workers Compensation, and Commercial Insurance.. Do you have questions pertaining to reimbursement? Do you know what to do if problems arise? With articles written by Callagy Law’s law team, this blog will focus on many common questions and concerns surrounding legal matters which can arise in the field of healthcare law.

It is important that medical providers comply with the insurance carrier’s Pre-Certification policy. Pre-Certification is the process of notifying an insurance carrier of the treatment you plan to perform on a particular patient prior to doing so. Failure to comply can result in penalties being applied to a medical provider’s billing, which cannot be balance billed to the patient.

While a medical provider must comply with the Pre-Certification process, the insurance carrier also has requirements they are required to meet in order to assess penalties. There are also many ins and outs of the Pre-Certification process that you should be aware of and many scenarios in which penalties should not be assessed by the insurance carrier.

In many instances the insurance carrier will attempt to assess penalties in situations inappropriately, and in scenarios where they failed to comply with the requirements placed on them. Callagy Law is an expert in fighting inappropriately applied Pre-Certification penalties, and has been successful on a multitude of occasions in obtaining full refunds for our clients of incorrectly assessed penalties. Here are some examples of cases in which Callagy Law has been successful in obtaining refunds:

Improper notice of the Pre-Certification process

Each and every PIP Insurance carrier is required to establish their own specific procedures as to Pre-Certification. This information is contained in each carrier’s Decision Point Review Plan (“DPRP”). The insurance carrier must provide both the medical provider and the patient with a copy of their specific DPRP so that they are properly notified of the procedures. If the insurance carrier fails to do so, no penalties can be applied. On multiple occasions this firm has obtained a return of penalties that were inappropriately assessed wherein the DPRP plan was not properly served.

Timely response by the insurance carrier is required

Additionally, New Jersey law requires an insurance carrier to respond to a provider’s pre-certification requests within 3 business days. If the carrier fails to timely respond, they are barred from raising any medical necessity defenses to the treatment performed.

In such cases, arbitrators have held that, essentially, authority to perform the treatment was granted by insurance carrier through their failure to timely respond to a pre-certification request. In a scenario wherein no evidence has been produced to indicate that an insurance carrier timely replied to a Pre-Certification request, Callagy Law has been successful in obtaining payment in full for the services requested in Pre-Certification.

Pre-Certification penalties cannot be assessed to the 1^st 22 dates of treatment

You, as the medical provider are required to notify an insurance carrier of your treatment of a patient within 22 days of first seeing the patient.

Callagy Law has successfully advanced the argument that, as a medical provider is not required to notify the insurance carrier of that they are treating apt until the 22^nd day of treatment, there can be no pre-certification penalties applied within those first 22 days.

No Pre-Certification required for pre-admission testing

In the event that a patient’s health required pre-admission testing prior to undergoing surgery, Callagy Law has successfully advanced the argument that such testing does not require Pre-Certification and penalties cannot, therefore, be applied to these services. To delay these minor diagnostic tests to obtain for the purposes of obtaining Pre-Certification would actually be counter-productive since such Pre-Certification would have resulted in a second office visit and additional charges.

In conclusion, Pre-Certification is a technicality through which insurance carriers often attempt to improperly assess penalties to admittedly medically necessary and approved treatment. Don’t let this happen to you. Contact Callagy Law for help in obtaining refunds of the penalties that have already been incorrectly assessed to your billing.

We hope you found the information provided in this article helpful to various questions you may have had concerning the healthcare industry. For information pertaining to our services for medical providers, please click here. Please note, Callagy Law has recovered over $175,000,000 for medical providers, and that number grows daily. Please free to reach out to Sean Callagy of Callagy Law at any time for questions you may have concerning personal and business matters. Callagy Law offices are located conveniently in Paramus, NJ. Beyond the scope of information, Sean Callagy has developed multiple areas of our healthcare legal practice and business coaching. Feel free to connect with us on Facebook, Twitter or LinkedIn! Additionally you can subscribe to our daily videos on YouTube.

Learn More About Callagy Law Here:

The PIP Pre-Certification Process | Callagy Law

Law and Entrepreneurship TV - Episode #23, #‎AskSeanCallagy‬

Exponential Growth and the Trajectory of Your Success

If you’d like to have your legal questions answered on the show, email Sean: scallagy@callagylaw.com

See more here: www.callagylaw.com/blog

Law and Entrepreneurship TV - Episode #23, #‎AskSeanCallagy‬

Monday, November 23, 2015

What To Do When The Party You Are Suing Passes Away

A Closer Look Into The New York Civil Practice Law and Rules

After searching various sources, we have found many people have questions when it comes to legal matters. If you are served papers, would you know what to do? Written by Callagy Law’s litigation team, this blog will focus on many common questions and concerns surrounding legal matters. These articles will give you a firsthand approach to what you should do and what can happen if a litigation issue arises.

One important aspect of a lawyer’s job is to prepare for unknown complications that may arise while representing a client. However, even the best lawyer may overlook a complication that will inevitably affect all parties: death. So what do you do when the party you are suing passes away? Different jurisdictions take varying approaches on answering this question.

In New York, the answer is governed by the New York Civil Practice Law and Rules (“N.Y. C.P.L.R.”). N.Y. C.P.L.R. 1015 states that if a party to a lawsuit dies and the claim for or against him or her is not thereby extinguished, the court has the power to order substitution of a proper party to proceed with the action. Moreover, N.Y. C.P.L.R. 1021 sets forth the procedure for substitution, allowing a motion of substitution to be made by the successors or representatives of the deceased party or by any party. (emphasis added).

It is important to note that in order to substitute a party, a court must obtain jurisdiction over the personal representative of the deceased. “To obtain jurisdiction over the personal representative, he or she must be served in accordance with CPLR article 3.” Horseman Antiques, Inc. v. Huch, 856 N.Y.S.2d 663, 663-64 (App. Div. 2008).

Lastly, there are other considerations a party should be aware of when substituting a party. While the following list of considerations is by no means exhaustive, it can give the reader a glimpse into legal issues that stem from substitution of parties. As a general rule, any orders of the court that are made between the date of death and the substitution are null and void. Singer v. Riskin, 2006, 32 A.D.3d 839, 821 N.Y.S.2d 120 (2d Dep’t). The death of a client revokes the attorney’s authority. Hyman v. Booth Mem. Hosp., 2003, 306 A.D.2d 438, 761 N.Y.S.2d 306 (2d Dep’t). The failure to substitute a party within a reasonable time is a basis for dismissal of the action. N.Y. C.P.L.R. 1021.

Learn More About Callagy Law Here:

What To Do When The Party You Are Suing Passes Away

New AND FREE to Share - Why Not with Sean Callagy #22

Why Not See If You’re Missing The Two Keys to Meeting Your Goals 10 Times Faster?

#MOMENTUMMONDAYS

Dear Kindred Spirits:

Good morning and welcome to Thanksgiving week!

We are following our new format, which makes this #MomentumMonday.

Whether you are looking to make another hundred million, save your first five thousand, or get in better shape, this is the place for you.

We all enter habitual patterns in life. These habitual patterns of action give us our results. Two of the key steps to achieving our goals are:

Having our goals clearly defined: and

Building massive momentum towards our goals through a massive shift to zone action.

So, how are you doing in these two areas?

There are a tiny select percentage of people who consistently achieve their goals at a much more accelerated rate than other people. Warren Buffett, Thomas Edison, a friend you know who always seems to make things happen or maybe you too, have produced rates at a different speed than other people.

Here is the key with Zone Action and exponential growth: are you consistently realigning your next action steps with what is most likely to bring about your most massive gain towards your goals?

In that single question lies the difference between exponential growth and stagnation.

For example, if a person wants to build business now, and they have a bunch of enormously valuable potential follow-up calls, and they are making lists of new people to call for potential sales, this is not Zone Action. When you stack the differences in Zone and Non-Zone Action on top of each other, it works like compound interest over time.

So, on this Monday, let’s break through your patterns and write down what your zone action steps are for today, this week and this month.

Use this letter, the Why Not Huddle and Law Library TV as your accountability check.

Do you need to make your sales calls, buy weights for your home, do crunches, call and apologize! Stop watching TV, or whatever?

The key to also understand is that these concepts apply to the President of the United States or a fifteen year old hoping to make the freshman baseball team. I have friends worth over thirty million dollars who are making less momentum on their fulfillment goals than people who are struggling to make their bills. These concepts apply to everyone in every area of life.

It’s your life. Attack your goals. Seize your momentum and move towards the life you truly want and settle for nothing less!

Have a Momentum filled Monday!

Please contact me if you have any questions whether they are about accelerating towards your goals or legal of any kind at scallagy@callagylaw.com or 201-261-1700.

In Your Service,

Sean Callagy

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New AND FREE to Share - Why Not with Sean Callagy #22

Law and Entrepreneurship TV - Episode #22, #‎AskSeanCallagy‬

Exponential Growth and the Trajectory of Your Success

If you’d like to have your legal questions answered on the show, email Sean: scallagy@callagylaw.com

See more here: www.callagylaw.com/blog

Law and Entrepreneurship TV - Episode #22, #‎AskSeanCallagy‬

Friday, November 20, 2015

Law and Entrepreneurship TV - Episode #21, #‎AskSeanCallagy‬

Exponential Growth and the Trajectory of Your Success

If you’d like to have your legal questions answered on the show, email Sean: scallagy@callagylaw.com

See more here: www.callagylaw.com/blog

Law and Entrepreneurship TV - Episode #21, #‎AskSeanCallagy‬

Law and Entrepreneurship TV - Episode #20, #‎AskSeanCallagy‬

Exponential Growth and the Trajectory of Your Success

If you’d like to have your legal questions answered on the show, email Sean: scallagy@callagylaw.com

See more here: www.callagylaw.com/blog

Law and Entrepreneurship TV - Episode #20, #‎AskSeanCallagy‬

Thursday, November 19, 2015

The Importance of Emotional Rapport: Part I | Callagy Law

As a senior liaison for Callagy Law, I am responsible for interfacing with medical providers to assist them with identifying and pursuing claims against insurance carriers in the areas of PIP (personal Injury protection / No Fault), Workers Compensation (WC) and Commercial Insurance (CI). In this capacity, I was first introduced to the concept of emotional rapport in the training and counseling provided by Sean Callagy, the owner and founder of Callagy Law.

Emotional rapport has two components. Rapport means to develop a close and harmonious relationship, while emotional rapport adds the second element of developing that relationship with an emotional connection. I have found that emotional rapport is the basis for developing a strong and trusted business relationship. It helps make a business relationship personal.

For some people this comes naturally. That is the case with me, but I was not aware of that fact until Sean pointed it out to me. For me, emotional rapport is the foundation upon which a complete relationship is built.

When meeting someone for the first time it is common to say “Hello. How are you?” The typical response is “Fine. How are you?” Both are very superficial, in no way even beginning to establish a rapport, never mind an emotional one. In contrast, I like to respond with something out of the ordinary, such as, “I am great. I just had a delicious lunch down the street.” Before you know it, you are talking about food, likes and dislikes, the neighborhood eateries, diets, and so forth. I prefer to respond to that usual question with something that tells the other person I am looking to connect at a deeper level than the surface level. This is so important because it not only assists in making conversation but it lets the other person know you care and are interested in them past the exterior.

Eventually, as you seek and acquire more information, you will be demonstrating that you desire a deeper and more meaningful relationship, which will help you move forward with a business relationship if that is what you are seeking. This more comprehensive knowledge will also allow me to customize our recovery and other legal services for that particular client.

I love it when I can help a medical provider seeking recovery services, and when I do so through a detailed understanding of their problem, interests, character and preferences, an outcome only possible through emotional rapport. It also enables clients to get to know me and all my quirks and shortcomings. We are all human and ride the rollercoaster of life, so why not connect on an emotional level. Give it a try. You can also click here to see what makes us different!

Should you need more information regarding developing emotional rapport, check out the series of YouTube videos featuring Sean Callagy. It really works.

Learn More About Callagy Law Here:

The Importance of Emotional Rapport: Part I | Callagy Law

New AND FREE to Share - Why Not with Sean Callagy #20

Why Not Take Care of Others AND You?

Dear Kindred Spirit:

How are you doing today?

That is the focus of today’s Why Not Huddle.

Today is a bit of a milestone. 20 straight weekdays we’ve now done the Why Not Huddle. It may sound small, but think about it. Try doing anything new and extra for twenty straight weekdays. It isn’t usually that achievable for folks.

BUT, it can be if you follow the approaches we’ve been sharing on the Why Not Huddles.

Thanks Taylor Gallo, my awesome and amazing Executive Assistant whose been getting up at the crack of dawn every day, transforming herself into a “morning person” (or maybe not!). In any case, Taylor, tremendous job!

Here’s to the next 1,000 episodes and early mornings!!

We are also going with a new format for our Why Not Huddles for the week. I want to focus on some key areas and give folks some weekly predictability for the Why Not Huddle.

Monday will be “Momentum Mondays”. We will focus on getting your week rolling and focusing on your goals, plans and acceleration within the process of exponential growth.

Tuesday we will talk about Time Mastery. Time is our precious element because of its finite nature. We will explore ways people can go from not having enough time to do anything, to having time do everything that is most meaningful and valuable. The misuse of time is one of the great inhibitors of our success.

Wednesday we become “Why Wednesdays.” Why, which we haven’t explored in depth, is the fuel, the energy behind our action and our results. It is what emotionally drives our behavior from the core.

Talk Thursdays will be all about the key skill set of our life: human communication. The power to, with integrity, influence, is what separates people in terms of success in relationships, sales, marketing, leadership and virtually anything you can think of.

Fridays are now Fun. On Fun Friday’s we will explore ways to inject fun, passion and adventure into all aspects of your work and play life. From discussing shark feed dives to virtually eliminating the difference between work and play, without fun, passion and adventure, what are we doing anyway? We will explore the most exotic to the simplest ways to find fun, passion and adventure.

Life is about progress in all areas. I’m excited about the new format. Let me know what you think?

Have a Why Not day!

By the way, if you know anyone with any legal need, our 100 person law firm is ready to help people with virtually any legal challenge. If we can’t help, we will know someone who can. Contact us now at scallagy@callagylaw.com or call 201-261-1700.

Thanks!

In Your Service,

Sean Callagy

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New AND FREE to Share - Why Not with Sean Callagy #20

Wednesday, November 18, 2015

When is an Injury Covered by Workers’ Compensation?

New Jersey Workers’ Compensation and the New Jersey Division of Risk Management | Helpful Information from the Callagy Law Team

The State of New Jersey is self insured for Workers’ Compensation pursuant to N.J.S.A. 34:15 and all such matters are handled by the “Division of Risk Management”. Workers’ Compensation is legislation to insure that employees injured on the job will be paid without regard to fault. The effect of the compensation statute on the covered “employee” is to take away the employee’s common-law remedies against the “employer” and to substitute in a remedy that requires the employer to pay the compensation benefits stipulated in the statute. The right to pay the compensation is the covered employee’s exclusive remedy against the employer.

In understanding this rule, the State of New Jersey is self-insured for Workers’ Compensation pursuant to N.J.S.A. 34:15-1, et. seq. All matters regarding case management and investigations are handled by the Division of Risk Management. All workers’ compensation obligations, including payments for medical treatment, temporary and permanent disability, are approved and processed by N.J.S.A.34:15-7 and N.J.S.A.34:15-43.

In order to be eligible for worker’s compensation, the first inquiry by the Division of Risk Management is whether the injury arose out of or in the course of the employee’s employment. If the injury is deemed compensable in nature, the injured worker is entitled to the full benefits of worker’s compensation. When medical treatment is warranted, the treatment is fully governed by the State of New Jersey, through the medical management facility, Horizon Casualty Services, Inc. If the injury results in lost time from work, the employee could receive monetary benefits through worker’s compensation, as well. The benefit is based on 70% of the employee’s base salary at the time the injury occurred, however, cannot exceed the rate that is allotted for the year, in question. The amount of the award is based on the percentage of disability that governs the injured body parts in question.

A reported injury is covered under workers’ compensation if the injury is a direct result of the employee’s employment and falls under the guidelines pursuant to N.J.S.A. 34:15-1, et. seq. A work related injury is an injury which occurs out of and in the course of State employment. “In the course of employment” is defined as when “employees are at their place of work, during the hours that they are expected to be there and engaged in doing the task that they were employed to do.” The employee could be traveling outside of the office. Overtime is also included. Moreover, the accident must result in “bodily injury.” Finally, the injury must be the proximate result of the accident the employee sustained. The employee may not recover benefits if there is no such causal relationship.

Under the Workers’ Compensation Statute (34:15-17), unless the employer shall have actual knowledge of the occurrence of the injury, or unless the employee, or someone on his behalf, or some of the dependents, or someone on their behalf, shall give notice thereof to the employer within fourteen (14) days of the occurrence of the injury, then no compensation shall be due until such notice is given or knowledge obtained.

You must notify the Division of Risk Management with your report of incident/accident within 24 hours of such knowledge, especially if there is a direct need for medical treatment. If no medical treatment is warranted, you are required to keep the report on file.

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When is an Injury Covered by Workers’ Compensation?

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Why Not Exponentially Increase the Power of Your Ability to Connect with Others?

Dear Kindred Spirits:

How do you feel about other people?

What do you believe about other people?

Are people bad? Are they selfish? Do you believe people are mean? Crazy? Unsupportive?

On the other hand, do you believe people have good hearts? Do you know that people deep down care about others? Do you think people want to help?

These beliefs are impacting two critical aspects to your life. These elements impact your relationships with other people, and therefore, impact your ability, whether it be in your business, career, or your personal life, to produce the results you want to achieve your goals and ultimate destiny.

So, what are these critical impacts for you?

First, what you believe about other people is controlling and impacting your feelings about communicating with other people, as well as your desire to help other people AND to ask for their help.

Exponential results require us to have strong and positive relationships with other people. If we believe people are, in general, self-absorbed mean creatures who only do things out of pure self-interest, then we will have a far more difficult time approaching and interacting with others because it will feel more “painful”.

The second impact is the most important though. This impact is what will not only increase our desire to interact with others, but will also increase their desire to help and interact with us!

To learn more about this, tune into today’s Why Not Huddle Episode 19.

You can find the Why Not Huddle by liking the Callagy Law Facebook Page or by subscribing directly on YouTube.

If you have any legal questions for your business, including issues with partners or shareholders, or any other legal or how to produce results questions, please contact us at scallagy@callagylaw.com or call 201-261-1700.

Have an amazing Why Not day!

In Your Service,

Sean Callagy

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Tuesday, November 17, 2015

PIP ARBITRATION PRACTICE TIP | CALLAGY LAW

THE IMPORTANCE OF FILING INTERNAL APPEALS PRIOR TO FILING A DEMAND FOR ARBITRATION

The purpose of this post is to help assist healthcare providers and owners with questions they have concerning their business or relevant knowledge in the field. The Callagy Law team is knowledgeable in many law practice areas and will frequently post topics ranging from Medical Revenue Recovery, PIP, Workers Compensation, andCommercial Insurance. We hope to have this blog shed a light on many common questions.

One of the most common defenses raised by insurance carriers as a basis to deny a medical provider’s claim for personal injury protection (“PIP”) benefits is failure to file internal appeals. Prior to filing a Demand for Arbitration on assignment from a patient, medical providers must comply with the PIP insurer’s internal appeal process. Thus, it is of critical importance for medical providers to abide by the PIP insurer’s internal appeal requirements, which can be found in the insurer’s Decision Point Review Plan (“DPRP”). Insurers generally forward their DPRP to treating medical providers after receipt of the treating provider’s 21 day notice letter.

The controlling regulation , N.J.A.C. 11:3-4.7(d)(8), requires that informational materials for policyholders, injured persons and treating medical providers shall include particular information including an explanation of the alternatives available to the provider if reimbursement for a proposed treatment, diagnostic test or durable medical requirement is denied or modified, including the insurer’s internal appeal process and how to use it. If the insurer does not have proof that it sent a copy of its DPRP to the patient and/or treating medical provider, it may lose the right to assert the defense of failure to file an internal appeal based on the fact that there was a lack of notice to the patient and/or treating medical provider of the internal appeals process.

It is important to review the PIP insurer’s internal appeals process since carriers have different requirements regarding whether both a 1^st and 2^nd level internal appeal must be filed, the deadlines for filing same and whether the appeal can be faxed or must be sent by regular mail or certified mail to a specific address listed in the DPRP. Medical providers must retain written proof that they forwarded the internal appeal(s) in compliance with the DPRP requirements, which can be by facsimile confirmation or certified mail return receipt.

There are two different types of internal appeals: (1) an appeal of an adverse determination based on lack of medical necessity and (2) an appeal of non-payments or under-payments, which can be based upon any of the following grounds:

Causation

Improper coding or down-coding of services

Usual, customary and reasonable rates

Lack of documentation

Coverage issues such as lack of cooperation

Improper pre-certification penalties.

Medical providers should keep in mind the importance of listing all potential bases of their appeal since the information listed on the appeal governs and may limit the arguments that may be raised in a later PIP arbitration proceeding.

In sum, medical providers should pay close attention to a PIP insurer’s DPRP plan’s internal appeal requirements. When an insurer denies treatment, a medical provider should promptly file an internal appeal of the denial to protect its rights to proceed to PIP arbitration.

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PIP ARBITRATION PRACTICE TIP | CALLAGY LAW