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

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Importance of Emotional Rapport—Part II | Callagy Law

Good Customer Service Is the Best Sales Technique | Callagy Law

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, and Commercial Insurance. We hope to have this blog shed a light on many common questions.

As a client liaison for a law firm (Callagy Law) that serves medical providers, I understand the importance of good customer service.  Our clientele expects us to help them in their recovery efforts against PIP/No-Fault insurance carriers, Workers Compensation carriers, and Commercial Insurance carriers.  Across the whole gamut of medical provider recovery against insurers, our Firm is expected to assist in the identification, assembly and pursuit of claims against carriers.

One of the functions of a client liaison in our industry–or any other for that matter–is to bridge the gap between sales/marketing and customer service.  We perform all three functions at various times in our work week.  The key to being successful in this environment is to realize all three are integral to each other.  In other words, the best way to get customers to return to you after you have won them over initially is to serve them well.  Maintaining a reliable client base is critical to success.  Moreover, it can serve as your best advertising, as when one person speaks to five others and they in turn speak to others, and on and on.  In the same way that bad reviews can kill any further inquiry from a potential customer, good reviews will do all the selling for you.  Any firm needs not only to keep customers happy, but to keep them so happy, they are anxious to sing your praises, whether asked to do so or not.

So what does good customer service actually do for us?  Let’s consider a current customer whose being contacted by a new potential client.  The new potential client will have a few questions to ask an existing customer.  Some of these are:

Are they receiving good value for the services they are receiving?

Were there any unpleasant surprises in doing business with the Firm?

Good customer service helps answer all these questions.   If we gave our customers more than they gave us, and we made sure we did so, then we did provide good value.  You always want to provide customers with more than they are paying for—that is what brings them value and what keeps them coming back.  You never want to provide less value than it is costing a client.

Good customer service also will help avoid any unpleasant surprises.  You must manage client’s expectations.  A good service representative will understand the processes of their customer and anticipate any problems.  This will lead to an effective and efficient relationship, as well as an easy going and comfortable one.

Good customer service is an effective marketing and sales tool and it does not cost anything.  The advertising it brings is free—your customer base becomes your spokesperson.  You make them happy, beyond anything they ever thought possible, and they become your champion to others who are looking for similar services.

Learning from others and seeking to find information is the first step to success. Whether you need questions answered about Medical Revenue Recovery, PIP, Workers Compensation, and Commercial Insurance., Callagy Law is here to assist you every step of the way. We are headquartered in Paramus, NJ and we are full service law firm that specializes in serving businesses, healthcare providers and individuals. Sean Callagy has assembled a team of attorneys that are exceptional leaders in their legal expertise and have been commended for providing exceptional legal services at every level. If you need a true hands of experience with a legal team, feel free to contact us at here and come meet with Sean Callagy himself. There is no substitute when it comes to working with a lawyer and law team that cares deeply about their clients. Feel free to search us on Facebook, Twitter or LinkedIn!

Good Customer Service Is the Best Sales Technique | Callagy Law

Medical Provider Applications In New Jersey Workers’ Compensation Courts

 What is “Usual, Reasonable and Customary” When There is No Fee Schedule for Healthcare Providers?

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.

Many may not be entirely aware, but the New Jersey Workers’ Compensation courts provide a forum for healthcare providers to challenge inadequate reimbursements from workers’ compensation insurance carriers where the underlying claim is for a patient injured within the course of their employment.  When a healthcare provider files its application with the Workers’ Compensation court, it seeks to obtain additional payment for treatment that was authorized and provided to the injured worker.  However, there is no fee schedule in place for workers’ compensation healthcare providers.  In these medical provider claims, the issue typically is not a contractual one; instead, the issue often is what constitutes the usual, customary and reasonable charges (or “UCR”) and the payment that should be made for a given medical service rendered to an injured worker.  When determining UCR, it is appropriate to look at a myriad of factors including but not limited to paid fees and all payments made to the carrier by commercial and non-commercial carriers.

The New Jersey Workers’ Compensation Court recently issued an opinion in the matter of Burn Surgeons of St. Barnabas v. Shop Rite concerning the payment of medical treatment in the context of a New Jersey workers compensation case.  In adopting the reasoning in Coalition for Quality Healthcare v. New Jersey Department of Banking and Insurance, 358 N. J. Super. 123 (App. Div. 2003), Judge Dietrich in Burn Surgeons accepted that it is appropriate to use paid fees rather than billed fees to make a determination as to the usual and prevailing fees in billing.  Judge Dietrich also accepted that there is a “balancing act between the attempts to contain costs while providing for a fair level of reimbursement for services rendered.”

Further, according to Task Force Report on Medical Provider Claims submitted on November 5, 2010, there are many factors that a Judge may consider in determining the UCR of a given medical treatment and the appropriate payment for said treatment.  While the following is not exhaustive, the Report provided that considering the following can act as a useful guide for the parties to consider in presenting proofs and likewise, to the jurist, in deciding a case: the fees customarily paid for like services within the same community; the fees paid to the same physician or medical provider by other payers for like treatment; the fees billed and the accepted payments for such bills by a given provider; the disparity in payments accepted from different sources (i.e. Medicare vs. PIP and commercial carriers); using commercial and/or private databases such as Ingenix’s Prevailing Healthcare Charges System (“PHCS”); the Medical Data Resource (“MDR”) database, and; Wasserman’s Physician Fee Reference (“PFR”) database to name a few.

As also promulgated by the Medical Provider Committee Report on December 9, 2014, UCR can be determined by looking to many programs: Fair Health Allowed Module, New Jersey Personal Injury Protection Fee Schedule, Provider/Carrier Commercial Payments, CMS, Wasserman Fee Schedule, , Pennsylvania Workers Compensation Fee Schedule, the New York Workers Compensation Fee Schedule, Federal Workers Compensation Fee Schedule, and any other probative evidence of paid charges received and accepted by the Medical Provider or paid by the carrier.

What This Means for Healthcare Providers

Under the Burn Surgeons case, when determining the amount of money to be charged for authorized medical treatment in a work-related injury, healthcare providers should use universally adopted databases, codes, and modifiers in order to determine whether the payments conform to UCR standards.

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!

 

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Medical Provider Applications In New Jersey Workers’ Compensation Courts

The Short-Term Impact of the Transition to ICD-10

On October 1, 2015, ICD-10 will go into effect, displacing ICD-9, which has been in place for 30 years.  ICD-10 will introduce greater detail and therefore greater complexity to medical billing and coding practices.  Indeed, In excess of 150,000 new procedure and diagnosis codes will be introduced.  As a result, it is safe to say that disagreements with carriers and controversy in interpretation will be commonplace for some time to come.  Because of this, medical providers need to brace themselves for what is sure to be increases in denials from carriers with a concomitant reduction in revenue.  Although these denials of course can and should be challenged at every turn, medical provider cash flow in the short run will certainly be impacted.

This is especially true in light of the fact that ICD-10 is not being mandated, thus far, at the state level.  Hence, PIP and WC claims can still be processed under ICD-9.  This gives PIP and WC carriers perhaps an additional opportunity for denial—they might request a bill submitted under ICD-9 to be re-submitted under ICD-10 and vice versa—anything to cause delay or denial in reimbursement.

Medical providers need to be especially vigilant and aggressive in their refusal to accept these denials and delays at face value, and should prepare themselves financially for a reduction in revenue, at least in the short run.

If you have questions regarding ICD-10, or any other legal questions, please feel free to contact Callagy Law today! If you are a medical provider, please refer to our Medical Providers page on our website.

 

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The Short-Term Impact of the Transition to ICD-10