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TPPA Explained

Posted by on Dec 28, 2014 in Prompt Pay | 0 comments

The regular working Joe who is provided with health insurance as part of his employment benefits seldom wonder about how the doctors, hospitals, and pharmacies he goes to gets paid. Perhaps he has this nebulous idea that they get paid much like any private service provider. In that he would be wrong.

Contracted third parties of health insurance carriers for employee health insurance, typically Health Management or Preferred Provider Organizations (HMOs and PPOs) are paid by the carrier after they make a claim. Ideally, when a clean claim is made, the service provider should receive payment within a few weeks. Unfortunately, that isn’t precisely the case. Most HMOs and PPOs habitually delay payment to their service providers, confident that they have a “captive” audience because these providers are generally reluctant to rock the boat and risk retaliation if they complain. By 1999, service providers in Texas had had enough of the losses they absorbed because of delayed payments, and by 2003 the Texas Prompt Payment Act (TPPA) had been enacted.

The TPPA is primarily designed to discourage the practice of certain insurance carriers to delay payment to their contracted service providers which include doctors, hospitals, and pharmacies. Violating the rules under the TPPA opens the carrier to interest charges on top of hefty fines for long-delayed payments of clean claims. However, there are limitations to what the TPPA covers, and the relatively new law is still undergoing significant revisions as the need arise. For example, it was only in 2011 that pharmacies became included in the list of covered providers.

Like any law, the TPPA is simple in aim but complex in enforcement; there are a lot of conditions and limitations that can confuse the non-legal mind. To more fully understand the salient points of the TPPA for purposes of determining coverage, a good resource can be found at http://www.williamskherkher.com/practice-areas/prompt-pay/.

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Punishing the Person who Harmed You

Posted by on Oct 19, 2014 in Personal Injury | 0 comments

Punitive damages are not generally awarded in personal injury cases, and in car accidents if a person in given punitive damages, they should be properly justified. Punitive damages are given in order to deter future similar actions from the defendant as well as other motorists, and they have no direct link to the injuries suffered by the plaintiff (although the award is still given to the plaintiff). In order for the plaintiff to receive punitive damages in a car accident, state laws should first be considered. There are states that require the defendant to exhibit gross negligence or intentional misconduct, while other states call from the defendant’s actions to be with malice, deceit, or reckless.

A person who is consciously disregarding another person’s rights, safety or life can be accounted for gross negligence. The added factor of being reckless or careless can make a negligence action grossly negligent. In order to prove actions of gross negligence, evidence should be presented by the plaintiff that would establish that the defendant acted with intent, deceit, or malice in order to cause harm or injury to the plaintiff. A reasonable basis for the punitive damages should be present in a personal injury or car accident case, otherwise the court may levy a monetary sanction against the plaintiff for unconvincing or no evidence that would justify the punitive damages. The court requires strong evidence of gross negligence or recklessness from the defendant that would justify the punitive damages because they would like to prevent and discourage senseless claims from plaintiffs who may take advantage of the situation.

The website of With Yvonne Fraser says that plaintiffs who are seeking punitive damages after a car accident should first consult with a personal injury lawyer who knows the laws in the state they are filing the case in. States laws vary regarding the awarding of punitive damages in injury cases, and often they have limits to the amount that can be awarded.

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The Difference between Salt and Salt-Free Water Softening

Posted by on Sep 15, 2014 in Water | 0 comments

There is a big difference between water softening systems that use salt and those that do not. Both systems have benefits and drawbacks; choosing one over the other will depend on your preferences.

The biggest problem that most homeowners have with hard (containing high percentages of metal cations such as calcium and magnesium) water is scaling. Hard water tends to deposit mineral residue on glassware (hence, spots!) and other surfaces such as bathroom tiles. These deposits also tend to build up in pipes, causing clogging and poor water flow. Furthermore, minerals in the wash results in dull colors and causes a yellowish cast in laundry, eventually damaging clothes. The obvious solution is to remove these destructive minerals.

Well, yes and no. Salt-based water softeners make use of sodium to replace calcium and magnesium in the water using an ion exchange process, effectively eliminating them and preventing the formation of scales. A water test would show that these hardness minerals are no longer present, making the water soft. In a salt-free system, the water is subjected to a catalytic system that converts the calcium and magnesium. Technically, the minerals are still there but they no longer form scales, so the water is said to be “conditioned.”

In terms of water composition, the only viable way to remove hard minerals in the water is by exchanging them for sodium ions to produce soft water. Moreover, you will use less soap for bathing as well as the laundry because soft water makes it easier to work up a lather, giving a feeling of cleanliness. Colored clothes will also look brighter and the water tastes and smells purer. The Austin water filter experts at American Water attribute this improvement to the removal of calcium and magnesium.

Some advocates of salt-free water treatment systems believe that it is better than the ion exchange system because they use no electricity, use less water as there is no need to purge anything as nothing is removed from the water, and no salt. Salt-free water treatment systems are virtually maintenance-free. However, the continued presence of these minerals still inhibits lather formation and there will still be spots on dishes. On the upside, scale formation is no longer a problem, there is no slick texture associated with “soft” water, and white fabric tends to be whiter.

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Solid Advice About Personal Injury That Really Helps

Posted by on Aug 21, 2014 in Personal Injury | 0 comments

Have you been injured due to the recklessness of another individual? Are you unable to work and pay your bills? You should start by hiring a good lawyer and building a strong case. Continue reading for more information on personal injury lawsuits.

According to the website of the Tennessee personal injury attorneys Pohl & Berk LLP, as an injured party, you should document your costs. Record any expenses or loss of income you incur as a result of your injury. Some of these documents may include insurance forms, medical bills, prescription receipts, and property damage repairs. If you miss work because of the injury, be sure you also document any lost wages. Document each expense as it occurs, while it is fresh in your memory. That way, they each are counted and kept track of in the course of your case. This can make all the difference.

Finding the right lawyer for a personal injury case often means looking at smaller law firms. Big firms don’t put this kind of case high on their to-do list, so you may find that your case is handed down to lower level attorneys with little experience, leading to a less positive outcome.

Speak with a bar association to determine the lawyers that are in your area that practice what you need. This will not provide you a ranking of the best lawyers, but will give you a good start on finding one. The American Bar Association is a good place for you to start this process.

When meeting with an attorney initially, make sure to ask any and all questions you have. These questions should include questions about your overall expectation of what the process of the lawsuit will be like so that you’re aware of everything involved. For you to feel comfortable throughout the lawsuit, you should be able to ask anything and everything of your lawyer.

Clearly, you are not required to do without what you need. You can take action when you are caused harm by the recklessness of others. Use these great tips to get the compensation you deserve from your personal injury case.

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An Alarming Rise in Deaths Due to Drug Overdose

Posted by on Apr 5, 2014 in News | 0 comments

The highest death rate in America’s working-age group has been identified to be drug overdoses.

Data from the Centers for Disease Control even show that since 2009, deaths due to drug overdose has been surpassing the number of deaths due to traffic accidents and firearms. The same results have been arrived at by the National Safety Council, a 501(c)(3) non-profit, non-governmental organization committed to safeguarding the life and health of the American public.

The misuse or abuse, either of prescription drugs or opioid analgesics among the working adults has been declared unintentional. However, the death toll, which, in 2010 alone, reached 38,329, has served as an alarm to both the federal and state governments, making them the see the need to do something that will combat overdose deaths.

The Good Samaritan 911 legislation, a legal protection offered to those needing medical help for themselves or someone else in the event of drug or alcohol overdose, as well as easy access to Naloxone, an overdose reversal antidote, are, meanwhile, being pushed by Drug Policy Alliance (DPA) as the immediate, sensible solutions to greatly lessen cases of drug overdose deaths.

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Principles of Product Liability

Posted by on Feb 27, 2014 in Dangerous Products | 0 comments

Product liability is the duty of the manufacturer or seller of goods or products which caused injury through defects in the products. Anyone who have suffered an injury because of defect in a product that they have bought and used have a Cause of Action against the people who have designed, made, furnished, and sold the product. Although most product liability cases are about the defects in manufacturing and design, consumers also have the right to file a personal injury lawsuit on instances where the manufacturer failed to provide necessary warning labels or instructions on how the products should be handled and used.

It is the duty of the manufacturers to provide information regarding the risks inherent in the products that they produce and sell, as well as provide the right instructions of how to use them, otherwise when an injury occurs due to this negligence they can be held liable for product liability. In order to prove that the manufacturer was negligent in providing warnings and important instructions, the plaintiff should show that the manufacturers was (1) aware of the dangers that comes with the product, (2) had the responsibility to warn their consumers, and (3) disregarded this responsibility resulting to the consumer getting injured while using the product. In court, the plaintiff should prove all three points in order to win the case.

The principle that applies to product liability is also the same basic principles that are used in personal injury lawsuits, and injuries resulting from negligence or recklessness of another person are grounds for claiming damages. Since personal injuries are a special type of tort law, it helps to have attorneys such as those from the Habush Law Offices to provide advice and representation during this type or tort case. It is important to determine which type of product liability claim you have in order to understand and clearly present your claims in court.

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18-Wheeler Crashes

Posted by on Feb 26, 2014 in Automobile Accidents | 0 comments

Truck accidents involving 18-wheelers is among the most destructive road accidents that can happen, and when they do the injuries and damages could cause serious financial distress to the victims. Filing a personal injury lawsuit could be a better and beneficial option; however, the problem is knowing who to file the lawsuit against. The truck driver may be held accountable for the accident since he or she was the one behind the wheel, yet there are also some legalities that can put the trucking company as well as other individuals at fault for the accident. According to the website of Schuler, Halvorson, Weisser, Zoeller & Overbeck, P.A., many factors can come about following an 18-wheeler truck accident, therefore knowing who made the mistake and who was negligent plays a vital role in claiming compensation for the damages.

Generally when 18-wheeler accidents occur, the blame usually falls on the truck driver so long as the victim was not the one at fault for the incident. However, there are instances where the trucking company can also be held responsible, and this is through employer liability. Employer liability, falling under the common law of “Respondeat Superior”, generally states that whatever mistake or wrongful act that an employee made is the responsibility of the employer, provided that the employee’s actions were not intentional and were done during the course of employment. Certain unavoidable circumstances are bound to happen during the course of employment, therefore these losses should be the burden of the employer. Employers are also viewed as generally more “deep-pocketed” than their employees, therefore have more capability to pay for damages and protect themselves with insurance as compared to their employees.

Trucking companies are not liable for wrongful acts made by independent contractors, therefore the Pohl & Berk, LLP website advises to check if the truck driver who caused the accident was an employee of the trucking company or an independent contractor. This bit of information is crucial because it establishes the relationship between the truck driver and the company, and whether the truck company has control over the detailed means and manner that the truck driver should follow. Furthermore, trucking companies can be exempted from any responsibility following 18-wheeler accidents when the acts where intentional. Intentional crimes such as assault and battery are not covered by employer’s liability since these acts are not connected to the business.

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Eagle Ford Shale Injuries

Posted by on Feb 23, 2014 in Workplace Dangers | 1 comment

After the recent boom on the Eagle Ford Shale and the big offers on employment, thousands of people have been drawn to work at South Texas. With the sudden rush of oil and gas workers, there has also been a rise in accidents, injuries, and death in the Eagle Shale Ford well sites. According to the website of the Chris Mayo Law Firm, working in this field of has some major risks, from well-site accidents, explosions, transportation accidents, and even contamination.

The dangers of injuries and accidents in the Eagle Ford Shale generally stems from the work environment. Because of the high demand for oil and gas, workers are forced to work long hours even on unfit weathers. This would cause serious strains on their health, inducing stress and fatigue to the workers. Lack of focus or concentration could then lead to errors in judgment, which is why there has been an increase in transportation accidents. These accidents have increased significantly since the Eagle Ford Shale boom. Many of these are commercial truck accidents, as oil tankers, pick-up trucks, and gravel truck all flood Interstate 181.The flock of commercial trucks have not only caused traffic and crowding in the area, but also have made drivers and other motorists feel fearful of their safety.

Because of the energy boom at Eagle Ford Shale, the once sleepy and quiet are of Texas has become busier and more populated. Because of the constant arrival of new workers and the transport of goods to and from the oil and gas wells, roads have become hustling with people and vehicles. With this comes the deterioration of the roads that made it less safe for travel. Fatigued workers who drive long hours on heavily congested areas is always in danger of getting into serious accidents, but it’s not just about the workers and the traffic. Factors such as road condition, driver’s distraction, and the rush to get things transported can also come into play.

Because of these dangerous conditions, it may seem difficult to prove negligence or recklessness to win a personal injury lawsuit against the driver or company at-fault of the accident. In order to determine a probable personal injury or wrongful death case, it helps to consult an attorney who can advice and investigate the situation first. Commercial truck accidents are not the only common accidents in the Eagle Ford Shale sites, oil and gas well explosions, chemicals, and leaks can also occur and could potentially endanger the health and well being of the workers. Knowing your rights would eventually help in protecting yourself from the risks that come with working in the oil fields of Texas.

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Vehicles and Consequences of Medical Mistakes

Posted by on Feb 16, 2014 in Medical Accidents | 0 comments

Recent studies have determined that various distractions in the operating room can significantly increase the chances of a medical error, particularly for younger and less experienced doctors. These medical errors can cause serious health risks and even death to the patients, therefore giving way to possibilities of medical malpractice lawsuits. Because operations and surgeries require focus and concentration, a simple distraction can make the doctor lose focus and he or she may end up committing a mistake during the procedure.

Distractions in the operating room can come in a number of ways; from noise coming from operating room equipment, to the chatter or even having music inside the operating room. Although surgeons do talk during operations, these are mainly about critical information regarding medications, blood supply, dosing, and other relevant data. Distractions in the operating room can account for miscommunications which can actually be prevented.

According to the summarized report posted in the medical journal Archives of Surgery, simulation in which the patient’s gall bladder was removed was done as a “virtual reality” operation. This procedure can be full of dangers and medical errors if the doctor is not focused or attentive enough. Because many gall bladder surgeries use robotics to aid in the operations, such as using the daVinci surgical robot, robotic surgical mistakes can also occur. Injuries such as burns, infections, and tears can be more dangerous because these are not immediately visible after the operation can are only noticed days after the patient’s surgery.

Younger and less experienced doctors are not the only ones who should be careful when doing surgery, as even older and more experienced doctors can also commit medical errors. Many have already faced medical malpractice lawsuits due to errors, from wrong or delayed diagnosis to complications resulting to Erb’s palsy to anesthesia errors. Although the study only involved research-year surgical students, distractions and loss of focus can happen to anyone, especially those who are under a lot of stress and are overworked. Being injured due to injuries after a medical error in the operating room can account for negligence, and are grounds for medical malpractice lawsuits.

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Financial Effects of a Divorce

Posted by on Feb 13, 2014 in Married Life | 0 comments

Most people going through a divorce can eventually discover that it can put a strain on their finances. The financial strains can lead them to consider filing for bankruptcy, but many people worry regarding the effects of filing for bankruptcy on their divorce case. Will it affect the outcome of the division of properties or the child support or custody? Contemplating whether or not to file for bankruptcy during a divorce depends generally on the timing and the type of bankruptcy you will file for.

Planning ahead could help lessen the burden of the divorce and bankruptcy; it could lead to less complication and cost. Filing a joint bankruptcy with your spouse before filing a divorce can save on court fees, but if you have already filed for divorce prior to the bankruptcy filing the effects can depend on whether you file for a Chapter 7 or Chapter 13 bankruptcy. Appealing for bankruptcy during a divorce case will not alter anything that establishes child support or custody; however, it will halt the ongoing proceedings connected to the division of properties.

Filing for bankruptcy will prompt the court to assign you with a bankruptcy trustee who will be in charge of administering your case. In the case of a Chapter 7 bankruptcy, the trustee will determine which of your assets belong to the property of the estate to determine if they can be sold to pay off your creditors. Joint properties can even be sold if you did not exempt the value of interest in the property; however your ex-spouse will be given the value of their share of interest should the trustee determine that their share in the property’s interest is not a part of your bankruptcy estate.

As for filing a Chapter 13 bankruptcy during a divorce case is ongoing, your properties will not be sold; nevertheless, the trustee is still required to conclude to total value of your property interests because this will eventually affect the amount of payment that will be given to your unsecured debts via your repayment plan. And because Chapter 13 bankruptcy takes between 3 and 5 years to complete, you and your spouse might require permission from the bankruptcy court in order to pursue the division of property in the divorce proceedings. It may seem difficult to think about handling both divorce and bankruptcy at the same time, thus it would help having the guidance of an attorney to handle the proceedings.

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