Organizations that fail to identify and eliminate fraud are losing hundreds of thousands of dollarsand many dont even know it! Many claims professionals dont have the time or resources to spot the red flags that indicate a fraudulent workers compensation claim, and even if they stumble upon one by chance, they fail to conduct a comprehensive investigation. Mario S. Pecoraro, CEO of Alliance Worldwide Investigative Group, provides proactive strategies that will save you resources, money, and time investigating claims. The twenty best practices he explores will help you: hire the type of employee who wont file a claim in the first place; engage in preventative maintenance throughout the life of a claim; determine who should conduct an investigation when a claim is filed; carry out the investigative process using a variety of tools. Filled with case studies demonstrating where investigations went wrong (and where they went right), youll be equipped to apply best practices and avoid common mistakes. Start saving money, and get the right team in place with The Claim Game.

The Model Rules of Professional Conduct provides an up-to-date resource for information on legal ethics. Federal, state and local courts in all jurisdictions look to the Rules for guidance in solving lawyer malpractice cases, disciplinary actions, disqualification issues, sanctions questions and much more. In this volume, black-letter Rules of Professional Conduct are followed by numbered Comments that explain each Rule's purpose and provide suggestions for its practical application. The Rules will help you identify proper conduct in a variety of given situations, review those instances where discretionary action is possible, and define the nature of the relationship between you and your clients, colleagues and the courts.

This combination textbook and workbook, explains each phase of the medical claim cycle, from the time the patient calls for an appointment until the financial transaction for the encounter is completed. Coverage includes types of insurance payers, basic coding and billing rules, and standard requirements for outpatient billing using the CMS-1500 claim form. It also emphasizes legal aspects related to each level of the medical claim cycle and the importance of the medical office employee, showing their responsibility for and impact on successful reimbursement. 3 separate chapters offer coverage of the basic concepts of medical coding. A comprehensive overview of the CMS-1500 claim form with step-by-step guidelines and illustrations thoroughly covers reimbursement issues and explains the billing process. Includes detailed information on various insurance payers and plans including Medicare, government medical plans, disability plans, private indemnity plans, and managed care. Stop & Review sections illustrate how the concepts presented in each chapter relate to real-life billing situations. Sidebars and Examples highlight key concepts and information related to the core text lesson. A companion CD-ROM contains sample patient and insurance information that readers can use to practice completing the accompanying CMS-1500 claim form, as well as a demonstration of Altapoint practice management software. Features completely updated information that reflects the many changes in the insurance industry. Contains a new chapter on UB-92 insurance billing for hospitals and outpatient facilities. Includes a new appendix, Quick Guide to HIPAA for the Physician's Office, to provide a basic overview of the important HIPAA-related information necessary on the job.

As Christians become more engaged with the reality of religious pluralism, many find themselves torn between two worthy goals - to be faithful to the lordship of Jesus Christ and to be open generously to possible truths found in other religions. In The First and the Last George Sumner offers a constructive way forward, showing how Christian theology can bring these two goals together. At stake in the current debate over religious pluralism is the issue not only of evangelism and mission but also of the Christian claim to the uniqueness of Jesus Christ. Sumner leads readers through the challenges and possibilities raised by this debate, and he outlines a distinctive new method for assessing from a Christian standpoint the claims and practices of neighboring faiths. The crux of Sumner's approach is what he calls "final primacy," a position that (1) sets non-Christian religions in relation to the unique mediating role of Jesus Christ and (2) relates the truth claims of other religions to the overall scheme of grace. Sumner goes on to demonstrate the effectiveness of this position in practical terms, using final primacy as a frame of reference for a number of twentieth-century theologies - namely, those of Barth, Rahner, and Pannenberg - and as a way of examining both Indian and African theologies against their respective backgrounds of Hinduism and tribal practices. Additionally, the book serves as an excellent introduction to the history of interfaith thought: Sumner both surveys how religious pluralism has been handled in the past and illustrates how the position of final primacy at once redefines and promotes its most pressing issue - interreligious dialogue. A provocative approach to religious pluralism sure to stir widespread discussion, The First and the Last provides valuable reading for anyone interested in theology, interfaith dialogue, and missions.

In 1948, three civilian engineers were killed in an Air Force plane crash while testing secret navigational equipment. The widows filed suit, but the Air Force, at the dawn of the Cold War, refused to hand over accident reports and witness statements, claiming the documents contained classified information that would threaten national security. In 1953 the Supreme Court sided with the Air Force in United States v. Reynolds, formally recognizing the "state secrets" privilege, a legal precedent since used to conceal conduct, withhold documents, block troublesome litigation, and, most recently, detain terror suspects without due process. A half century later, the government revealed the "top-secret" information--there were no national security secrets, but rather a shocking chronicle of negligence. This book tells the story of this shameful incident, and the dangerous consequences of this historic cover-up: the violation of civil liberties and the abuse of constitutional protections.--From publisher description.

This is the best book you can own on the strategies YOU need to use to get the insurance companies to pay you ALL the money you are entitled to collect when you have a claim. Wouldn't you agree that nothing else matters about insurance other than getting the claim PAID IN FULL? In this book, you will learn: &ndash The games and scams insurance companies use to cut costs and keep claim payments at the lowest amounts possible &ndash When it's the right time to use an attorney &ndash How you can take control of your claim, and not allow the insurance company or claims adjuster to control YOU &ndash What a Public Adjuster is, and the valuable help you can get from Public Adjusters &ndash That the insurance adjuster is NOT there to help you &ndash and much more You will learn: &ndash What to do when you have a car accident...BEFORE you open the car door or talk to anyone &ndash How much MORE money I collected (thousands!) in the two little claims I had while writing this book &ndash About Diminished Value on automobiles, and how it can cost you THOUSANDS if you don't fight &ndash About cheap aftermarket auto parts that insurance companies LOVE, but leave you less safe &ndash And so much more Ask yourself these questions: Do you carry a spare tire and jumper cables in the trunk of your car? Do you have a toolbox at home? Have you ever bought a book or read an article that showed you how to fix something? Do you own a first aid kit? Do you have a fire extinguisher or smoke alarms in your home? Why would you do ANY of those things? Answer: So you are prepared BEFORE something bad happens. READ THIS BOOK BEFORE SOMETHING BAD HAPPENS TO YOU!!! READ THIS BOOK AFTER SOMETHING BAD HAPPENS TO YOU, TO KEEP IT FROM GETTING WORSE! This book should be on the shelf in EVERY HOME. This book should be in EVERY automobile glove box.