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8581 Santa Monica Blvd # 703 West Hollywood CA 90069

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What’s Covered? Water Damage and Insurance #water #damage #insurance #claim #tips


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Over the past nine years water damage claims have risen to become 50% of all home insurance claims. Water damage can be costly and difficult for property owners and renters to recover from. Many people assume their insurance policy will cover water damage but there are different kinds of water damage, which may or may not be included in a standard property insurance policy. We’ve created a quick guide to help explain how each kind of damage could occur and what it means for your insurance.

Water Damage
Your property insurance should include coverage for any sudden or accidental discharge of water in your home. This includes coverage for water line breaks or if any of your appliances overflow or leak. You are also covered if hail or wind causes a hole in your home through which water enters and causes damage. An easy way to know whether the damage to your home qualifies as water damage is to consider the source of the water. For insurance companies, water damage refers to damage caused by “clean water” or water that hasn’t entered your home from the ground or sewer.

Sudden and accidental bursts of plumbing pipes and appliances are covered by residential insurance policies, but there are specific policy requirements and limits for these situations. If you are going to be away from home for more than a day, be sure to turn off your main water supply and appoint a caretaker to check your house regularly. If you don’t, your property insurance policy may not respond to a loss, meaning any water damage claim as a result of frozen or burst pipes could be denied. Each policy has different requirements in terms of inspection frequency and water supply. If you’re heading on vacation or away on business, your BrokerLink broker can confirm what your specific policy requirements are to ensure your coverage remains valid.

Sewer Back-Up
In contrast to the “clean water” of water damage, sewer back-up involves damage caused by “dirty water”. This includes any water coming into your home from pipes, drains, septic tank, eaves troughs or down spouts. Sewer back-up can happen for a variety of reasons but the most common is when rain or melting snow overwhelms the city sewer system.

Sewer back-up coverage is not included in your property insurance policy but can be added as an optional coverage. Homeowners in some areas are more likely to require this coverage as their homes may be more vulnerable to flooding and back-up. The cost of adding this coverage can be minimal compared to the cost of repairing your home and additional living expenses if you cannot reside in your home. If you’d like to learn more about sewer back-up coverage, be sure to call your local BrokerLink broker .

Overland Flooding
Overland flooding refers to any situation where water overflows onto dry land from a body of water, causing damage to homes and cars. This kind of water damage made headlines last year when Southern Alberta experienced flooding from overflowing rivers due to heavy rainfall and rapidly melting snow .

There is currently no insurance coverage available in Canada for overland flooding. According to the Insurance Bureau of Canada. this is because only a small percentage of the population is at risk for overland flooding. Those who are most vulnerable are those living in areas prone to flooding, such as flood plains or near lakes and rivers. Since the majority of homeowners aren’t exposed to this risk and would not share in the cost of the coverage, it becomes too expensive to provide flood insurance for homeowners who would need it.

Now that you know the different kinds of damage caused by water, how can you protect your home and your belongings?

Inside your home
• If your home was built before 1950, make sure you don’t have any galvanized pipes. This type of plumbing has a lifespan of 50 to 75 years and corrodes easily, leading to leaks and bursting.
• Keep an eye out in the bathroom. Small cracks in your tub and shower grouting can allow water to penetrate the walls which can cause rot and mould.
• Install flood-prevention devices. Not only could they protect your home, but they could qualify you for a discount on your insurance. For a quick guide to these devices, click here .
• After a rainstorm, check your basement. If you find any water, it may mean you have foundation cracks needing repair or your draining system needs to be replaced.
• Most washers come with rubber water hoses which can burst as they age. Inspect the hoses regularly for cracks or signs of wear. If you can’t remember when they were last changed, it’s a good idea to replace them.
• Keep a record of your belongings using our home inventory checklist. Having a list of items can be extremely helpful in case you do sustain water damage and need to file an insurance claim. Consider storing valuable items on higher levels of your home since the basement is one of the parts of your home most vulnerable to water damage.

Outside your home
• Shovel snow away from your home and make sure there aren’t any banks building up against the sides. The goal is to keep any melting snow away from your foundation as it can seep into your basement.
• Check to see which way the ground slopes around your house. If the ground slopes towards your home, water can pool next to your foundation after a rainfall or thaw.
• Clean your gutters and eaves troughs clean and make sure the water is draining away from your home.
• Inspect your roof for worn or missing shingles as well as any areas where the metal flashing is bent or unsealed.
• Make sure you always turn off exterior water lines from the controls inside the home and drain the water lines to the outside any time the weather drops below zero.

Your home is likely your most valuable asset so you want to make sure it’s protected. If you have any questions about the different types of water damage, your home insurance policy or flood prevention devices, we’d be happy to answer them. Visit your local BrokerLink office or give us a call today.


Virginia Dog Bite Laws #dog #bite #claim


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Virginia Dog Bite Laws

If you have been injured in a dog bite incident in Virginia, or if you’re an animal owner who might be facing a lawsuit, you need to understand the different state laws that could affect your case. In this article we’ll look at dog owner liability for bites and other injuries, the role negligence plays in a dog bite claim, and possible defenses a dog’s owner might raise when facing a dog bite lawsuit in Virginia.

Virginia’s Dog Bite Law

Unlike many other states, Virginia does not have a specific dog bite statute. Instead, Virginia dog bite and dog-related injury cases are handled according to rules laid down in Virginia court cases over the years.

Virginia dog bite claims usually follow a “one bite” rule. Under this rule, a dog’s owner may only be held liable for injuries caused by their dog if the owner knew or should have known the dog might act aggressively against a person or pet — for instance, because the dog had bitten someone once in the past.

Despite its name, the “one bite” rule does not apply only to dog bites. It also applies to other kinds of harm a dog might cause. For example, if the dog is known for jumping on people, then a person who is injured when the dog jumps on her and knocks her down may decide to seek damages from the dog’s owner.

Negligence and Negligence “Per Se” in Virginia Dog Bite Claims

If the dog has never injured a person before, a person harmed by the dog can still try to seek damages from the dog’s owner in Virginia. However, in order to seek damages when the owner had no prior knowledge, the injured person will have to demonstrate that the owner had a duty to use reasonable care to restrain the dog, and that the owner’s failure to meet this responsibility caused the injury. If the person who was injured can establish the dog owner’ negligence in this way, then liability will also be established.

In some cases, the injured person might argue that the owner’s behavior constituted negligence “per se” — or negligence in and of itself, without any need for further proof. For example, suppose that a pedestrian is walking in a park one day when he is bitten by a dog. The dog’s owner was walking the dog in the park but did not have the dog on a leash, even though city ordinances require all dogs to be on leashes while they are in the park.

Here, the injured pedestrian might argue that the dog owner’s failure to leash the dog was negligence per se, because the owner violated the city ordinance. If the pedestrian wins this argument, he can show that the dog’s owner should be held liable for damages related to the dog bite.

(A note: All dog bite claims in Virginia must be filed before the state’s statute of limitations expires. Learn more about the time limits for filing dog bite lawsuits in Virginia courts .

Criminal Penalties for Dog Bite Injuries in Virginia

Code of Virginia section 3.2-6540 imposes criminal penalties on the owner of a “dangerous dog” whose animal causes injury or death to another person. If an owner’s dog is listed on the state’s registry as a “dangerous dog,” and it causes harm, potential criminal penalties include:

  • conviction of a Class 2 misdemeanor if the dog “attacks and injured or kills” another person’s cat or dog
  • conviction of a Class 1 misdemeanor if the dog bites or attacks a human, causing injury, and
  • conviction of a Class 6 felony if the owner or keeper of the dog “is so gross, wanton, and culpable as to show a reckless disregard for human life, and is the proximate cause” of the dog causing bodily injury to another human.

Criminal penalties may also be imposed for owners of dangerous dogs who fail to follow Virginia’s rules for registering and keeping dangerous dogs.

If criminal charges are filed, a person who was injured by a dangerous dog may still file a civil lawsuit. Criminal charges are filed by local or state prosecutors, while civil lawsuits are filed by the injured person directly.

Defenses to a Virginia Dog Bite Claim

In a civil lawsuit involving a dog-related injury, the most common defense raised in Virginia is that of contributory negligence. In a contributory negligence claim, the dog’s owner argues that the injured person was partly to blame for the injuries suffered.

For example, suppose that a child is teasing the neighbor’s dog with a stick when the dog bites the child. The dog’s owner may argue that the child provoked the dog, which led to the bite. In other words, by provoking the dog, the argument goes, the child contributed to his own injuries and should therefore not be allowed to recover damages.

In Virginia, contributory negligence is a complete bar to recovery. This means that if the injured person is found to be even one percent at fault for their own injuries, they are barred from recovering any damages at all. For more information, see What if I am partly at fault for my dog bite injuries in Virginia ?

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An overview to the medical claims process from coding to billing, claim processing in healthcare.#Claim


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Medical Billing and Coding Online

The United States healthcare system is trillion-dollar industry, which includes pharmacies, pharmaceutical companies, medical equipment manufacturers, and medical care facilities. The complex infrastructure that keeps this industry, which is responsible for the well-being of millions of Americans, running on a day-to-day basis relies on specialized professionals tasked with overseeing these operations. One such system is the medical claims process. The claims process can be summarized as a dual interaction between two of the largest and most important pieces of the healthcare system: healthcare providers and medical insurance companies.

The relationship between policyholders, healthcare providers, and insurance companies is essential to understand before tackling the details of the medical billing and coding process.

A healthcare provider is any facility or practice where you receive and are billed for a product or service related to your personal health. Healthcare providers include hospitals, private clinics, and pharmacies as well as specialized care providers like nursing homes, in-home caretakers, and chiropractors.

Health insurance companies subsidize medical care for qualifying patients, called policyholders. Health insurance is not mandatory in the U.S., but many Americans have insurance coverage, whether they purchased it privately or obtained it from their employer or the government. Insurance policies vary, but they all operate under the same business model: policyholders pay a certain amount of money each month or year to the insurance company, which is called a premium. If policyholders need procedures for which they qualify, the insurance company pays for that procedure, either in full or in part.

A policyholder is any individual who has purchased health insurance. For example, a young adult looking for a basic insurance plan may purchase a policy where the insurance provider will pay for all medical bills that cost more than the deductible, which is a pre-arranged amount that the policyholder must pay out-of-pocket before insurance coverage kicks in.

The medical claims process is initiated when a policyholder goes to a healthcare provider for a medical service, which can be anything from obtaining a monthly prescription to major surgery. After the policyholder receives the service, they are usually financially responsible for a deductible, which is the amount of money that the policyholder agrees to pay before their insurance starts. The policyholder gives their insurance information to their healthcare provider, and the transaction between the policyholder and healthcare provider is complete.

Behind the scenes, the transaction between healthcare provider and insurance company begins. The healthcare provider records all the medical services and their costs offered to the policyholder. This record is known the medical claim, or bill. While working for healthcare providers, medical billers and coders are responsible for creating this record and sending the claims out to the policyholder’s insurance company, which has three options. It can:

  • Accept all expenditures and pay the bill in full
  • Deny the claim on account of a billing error (like incorrect patient information). The bill is then returned to the healthcare provider to be corrected.
  • Reject the claim outright, usually on account of the services not being covered within the health plan. The policyholder then pays for the service out of pocket.

Working with Insurance Providers

The two major types of insurance providers are managed care plans and public insurance. Learn how to handle both types of coverage below.

Managed care

A large portion of insured Americans receive coverage through their employer, usually through managed care plans. These insurance plans work with a specific group of doctors, hospitals, pharmacies, labs, equipment vendors, and other care providers. Individuals insured under managed care plans seek medical services within this managed care network. The three main components of managed care are preferred provider organizations, health maintenance organizations, and point of service plans.

  • HMOs require their policyholders to receive most or all of their medical care under the insurance provider’s managed care network. They also require policyholders to select a primary care physician. If HMO policyholders see a specialist without a referral from their primary care physician, or seek treatment outside of the managed care network, they will most likely have to pay medical bills out of pocket.
  • PPOs also have a network of preferred healthcare providers they request their policyholders to seek treatment from. However, unlike HMOs, individuals do not need to select a primary care provider. Also unlike HMOs, if an individual seeks treatment outside of the managed care network, they can pay the out-of-network healthcare provider directly and possibly get reimbursed for their medical expenses.
  • Point-of-service Plans: Point-of-service plans form a hybrid between PPOs and HMOs. As with HMOs, point-of-service plans allow you to select physicians and services from within a dedicated network of providers. Unlike HMOs, patients can receive care from out-of-network providers, but they will likely have to pay a deductible.

HMOs and PPOs differ in the insurance claim process. All healthcare providers within a managed care network must file a claim with the HMO. So long as services are rendered in-network, policyholders are not required to file anything themselves, and healthcare providers may not bill the policyholder directly. In the case of PPOs, policyholders may have to file a claim to their insurance provider if seeking treatment outside of the managed care network. Filing claims to insurance providers isn’t necessary for POS plans.

Public insurance coverage

The government is also a major provider of insurance coverage in America, through public programs called Medicaid and Medicare.

  • Medicaid is a health service program designed for low-income individuals and families. Medicaid recipients receive health coverage decided by the state in which they reside, though some coverage is federally mandated, such as inpatient and outpatient hospital care. Within this system, states make payments on a fee-for-service system or through arrangements with HMOs.
  • Medicare is another government-funded insurance program for the elderly. Like Medicaid, certain medical services must be covered for Medicare recipients, such as hospital stays and nursing care. This basic coverage is called Medicare Part A. Recipients may also receive coverage in Medicare Part B, also called Supplementary Medicare, for services such as medical equipment, x-rays and labs, and outpatient hospital visits. Recipients of Medicare Part B must pay a monthly premium and pay an annual deductible. There are also Medicare Advantage plans where users can create custom plans that meet their specific needs.

Wrapping Up Course 1

The medical claims process is a dense, complex, but no-less crucial component to the healthcare industry. The following courses will dive deeper into the individual facets of the process referenced in this overview, including coding, insurance providers, medical billing terminology, and medical billing errors. These courses are designed to expand the knowledge base and technical skills needed to become a certified professional medical biller and coder.


Insurance Claim Advocacy #insurance #claim #advocacy, #insurance #claim #consultants, #professional #insurance #consultants


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Specialists in Claims Mediation and Resolution for commercial & business clients

Necessary and essential to a business, insurance is all too often purchased on price and or without a detailed understanding of the cover provided, rather than as a valued and thought through requirement, inevitably leading to conflict when a claim is disputed or when insurance is declined.

Against this backdrop Flaxmans negotiate and settle business insurance claims, and act as expert witnesses to the judiciary and courts on matters of insurance and broker practice.

In addition the company designs and implements bespoke insurance packages for businesses and organisations where off the shelf products are not applicable and in providing advice to Board and senior operational levels in the management of insurance and claims risk and their individual professional and personal liability.

Flaxmans typically work with:

  • Banks, Corporate Institutions, international organisations and large PLC s
  • Business owners of SME companies
  • Finance directors and company secretaries of FTSE companies
  • Trustees and Governors of charities and foundations
  • Professional firms such as accountants, architects, lawyers, insurance intermediaries, consulting engineers and surveyors.

Insurance Brokers

Many of our clients are referred to us from their insurance brokers. They come to us when a claim is rejected or disputed and we then work with the client and the broker to get it resolved. Brokers also ask us to provide reviews of insurance placement for their clients and to assist them in designing more complex insurance programmes.

Trade Associations and Professional Bodies

We advise trade associations and professional bodies on matters concerning claims, potential liabilities, risks and the management and mitigation of risk, both their own and those of their members’.

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CRUSADER – Claims Dispute Insurance

It seems from the feedback so far that we are launching our Claims Dispute Insurance* at exactly the right time. We are describing this unique insurance as “The Champion in your back pocket”.
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EstimateWriters Xactimate insurance claim estimate writing service home page #xactimate, #estimate, #eagleview, #eagle #view, #contractor,


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Xactimate Estimate Writing Service

We are a property damage estimating service specializing in writing claims invoices using Xactimate software. Serving the insurance and restoration industries, our clients include contractors, homeowners, adjusters, and lawyers. We do not represent you or advise you, except as to the best accepted methods of writing your estimate. Your logo and information is what appears on your estimate, not ours.

Estimate Writers is staffed by Xacimate instructors, former adjusters and contractors that understand all aspects of the claims industry. It was the first and is still the most experienced online service of its kind. We have written thousands of estimates for every imaginable type of damage. Finally, our trade specific forms make submitting your info a breeze.


How EstimateWriters Can Help You?

We will write your Xactimate estimate for you. It can be done to initiate a new claim or to respond to an adjusters estimate that you feel is too low or missing necessary items.

Our clients call on us when they are:
Not skilled in Xactimate preparation
Too busy to handle their work flow
Stuck trying to do a complicated estimate

Our Clients Include: Restorations Contractors, Remodeling Contractors, General Contractors, Remediation Contractors, Water Extraction Contractors, Drying Contractors, Emergency Services Contractors, Painting Contractors, Roofing Contractors, Cleaning Contractors, Siding Contractors, Specialty Contractors, Adjusters, Lawyers, Property Management Companies, Building Owners, and Homeowners

We Write Estimates for Damages From. Collapse, Sewer and Drain Backup, Earthquake, Fire, Flood, Freeze, Hail, Hurricane, Weight of Ice and Snow, Lightning, Sewage, Smoke Cleaning, Theft, Tornado, Vandalism, and more.

Other Services Include:

  • All Other Causes of Loss Estimates
  • Adjuster Estimate Re-Writes
  • Sketch Assistance

Contact Information:
EstimateWriters, LLC
Tax ID: EIN # 47-3696788

Our Most requested Estimates

Pricing

Roofs – use of our forms is required
Without anEagleView
$49 – Our basic roof estimate when written from information and calculations provided solely by the client.

With anEagleview purchase:
$79 small (up to 20 Squares)
$99 medium (20-40 Squares)
$129 Large (over 40 Squares)
commercial at $139 per building
These prices include the Xactimate estimate and the best available Eagleview Roof report

Siding – use of our forms is required
$59 – When written from information and calculations provided solely by the client.
$139 – When ordered with an EagleView Walls purchase.

Smoke Cleaning Estimates – use of our forms is required
3% of the total – $100 minimum

Floods, Fires, Drying, and most other Losses
For an estimate written from scratch, our fees are based on 1% of the total estimate, $100 minimum. This is for an estimate written in our office with information that you provide on our forms. Your information can be sent to us by fax, phone or email. Payment can be made by PayPal or credit card which is for your protection.

Adjuster’s Rewrites
For the rewrite of an existing adjusters estimate to include your additions and changes, our fee is $1 per line item to rewrite the adjusters estimate, plus 1% of the new increased total.

What is Xactimate?
It is the software that we use for preparing your estimates. It is for estimating property damage. Created by Xactware, it is used almost universally by insurance companies to price materials and labor. Xactimate provides specific pricing for every zip code in the US and Canada, updated monthly. An Xactimate estimate outlines the specific items necessary to restore the property. Making your bid without knowing the Xactimate pricing is not advisable.

*We often use EagleView’ Technologies Roof and/or Walls Reports. Both are respected by the insurance industry. With these amazing reports and some additional information from you using our forms, we create an impressive and accurate estimate for you. If you already have an EagleView Report, please send it with your submittal.

How to Get Started – Generally Speaking
Find more specific information on pages pertaining to your type of estimate.
Send us everything or anything that you can:

Xactimate helps us determine with accuracy the cost of mitigation and repairs pertaining to a covered insurance loss. The settlement of a claim is often frought with disagreement as to what is fair and reasonable in achieving the goal of restoring the contractural rights of the insured. A well written estimate represents the negotiating posture of the party explaining its opinion of the right corrective course.


Turn Around Time – What to Expect
Roofs and Siding Within 24 hours after your submittal and payment, Sundays not included. Possibly additional 1-3 days sometimes, for orders that include an EagleView purchased through us.
All other estimates – Typically, the turn around time is 1-2 days. Busy periods and large estimates may take longer. Call us before submitting, if you are sweating a deadline. We want your business.

You Have a Fantastic Opportunity
As a part of the insurance restorations industry, you should provide Xactimate estimates. Xactimate is the primary billing software of the claims industry. Without it, you cannot price the job appropriately. Most of the insurance people that you negotiate with, use only Xactimate prices. Sometimes it’s like insurance people speak another language. We write Xactimate estimates for you. At your direction, we include all the items that you believe are necessary to complete the repairs. Your estimates are organized and understandable, and done by professionals. We’ve done thousands of estimates and are very highly skilled. Our Xactimate training has included many formal courses, continuing education, and for some of us, practical application as field adjusters. But our experience, having seen estimates written by thousands of others, made us the best at what we do. The best of the best.

RoofEstimators.Com is in no way affiliated with or endorsed by Xactware or Xactimate . No guarantee of success in dealing with, or negotiating with insurance companies is guaranteed by RoofEstimators.com. RoofEstimators.com accepts no liability for the reports provided in excess of the fee charged. Our reports are expected to be used by experienced professionals who will preview all reports before presenting them to others. Figures provided are based on quantities and materials specified to us by our clients. All contents, including design, of this website are protected under international copyright law and are the exclusive property of RoofEstimators.com. Reproduction of any kind is strictly forbidden copyright 2010 RoofEstimators.Com. RoofEstimators.com is a division of EstimateWriters.com, LLC


American Medical Billing Association – Medical Billing Website #medical #billing, #medical #billing #association, #amba, #american


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2017 AMBA National Conference – Treasure Island
Vegas, Oct. 26-27, 2017

Our mission as a medical billing association is to provide industry and regulatory education, networking opportunities for our members, to be able to share information and ideas and to market our member’s abilities and professional services as a group.

We offer the only medical billing specialist certification exam(CMRS) recognized nationally by billers, coders, employers and other entities. The American Medical Billing Association (AMBA) encourages and relies on member participation and input.

Our National Medical Billing Advisory Board provides input, ideas and advice to AMBA leadership for the betterment of our association and our profession.

Our ultimate goal is to provide members with medical billing and related resources that enhance knowledge and skills to develop new ideas and technology, collectively increasing and realizing true industry growth and leadership among medical billers and consultants.

AMBA was formed and is targeted toward providing assistance for doctor’s office and independent professional medical billers with similar needs, interests and goals. We celebrated our 16th Anniversary in serving doctor’s office and independent Third Party Medical Billers in 2014.

Our focus is centered on: Networking among peers
Providing information and knowledge
Offering continuing education and ongoing research
Developing innovative ideas and new technologies
Gaining recognition for our accomplishments
Providing leadership in the industry; and
Offering fellowship and fun to members

Member participation, ideas, networking and support are encouraged and appreciated.

Here at the American Medical Billing Association, our members are our partners in success through support, participation, ideas and growth!

Individual Membership $99

Business Membership $199