Fighting Medicare Claim Denials

When an insurance company denies a claim in whole or in part, it is possible to appeal their decision. The same is true with Medicare claims...and in fact more than half of Medicare appeals are successful. If you, a family member, or a friend have had a Medicare claim denied, the following information can help you successfully appeal the decision:

Time Frame: If your Medicare claim is denied for less than the full amount, you can ask for a "redetermination" but you must do so within 120 days. Download the Medicare Redetermination Request form at http://www.cms.hhs.gov/cmsforms/downloads/cms20027.pdf, or call 800-633-4227 to receive a copy.

Common Denials: The denial you received will include an explanation, which you will need to contest in your appeal. Ask your doctor to write a letter addressing the reasons in the denial and include this letter with your appeals form.

Common denials include:
The treatment, prescription, or medical service is unlikely to cause your health condition to improve: Fight this by having your doctor write a letter explaining why the care is necessary. Medicare is required to look at your total condition, not just your chance for a full or partial recovery.

You are likely to require care for a very long time: Medicare coverage is not limited to treatments that work quickly, so ask your doctor to write a letter explaining that the treatment is making some positive difference or is expected to.

The prescription dosage level is greater than what is normally prescribed, or the drug prescribed is not normally prescribed for your health problem: Have your doctor write a letter explaining why the unusual drug or dosage is medically necessary. For instance, you may be allergic to the medicine normally prescribed.

You do not qualify for Medicare-covered home care because you are not homebound: Under Medicare rules, homebound does not mean that you are completely unable to leave your home or that you are confined to a bed. It does mean that you require assistance and that it takes considerable effort for you to leave your home. Ask your doctor to write a letter describing in detail how difficult it is for you to leave your home.

Be Persistent: If your first appeal is denied, you can file as many as four more appeals. And the more appeals you file, the greater your odds of success. While your first appeal is made to the same group that denied your initial claim, subsequent appeals are made to independent arbiters.

For more information, visit www.medicareadvocacy.org

Bernanke, Greenspan agree cash arms firms for slump

Corporate balance sheets of American businesses – other than banks – are in better shape today to face a recession than in previous economic contractions because they have banked some half a trillion dollars in cash, reduced short-term debt and slashed inventories, according to former Federal Reserve Chairman Alan Greenspace and current Fed Chairman Ben Bernanke. That means companies aren’t likely to be as reliant on beleaguered banks to fund their operations.

MAKING SENSE OF THE STORY FOR CONSUMERS

• Since the last recession, disciplined companies have been rewarded with 20 consecutive quarters of double-digit growth in profits. S&P 500 companies alone have amassed about $615.5 billion in cash, compared with $352.4 billion prior to the 2001 downturn and $95.5 billion prior to the 1990-91 recession.
  
• Debt as a percentage of net worth for non-bank companies was only 63 percent in the fourth quarter of 2007, compared with 93.6 percent in 1990-91.
  Together, these figures indicate that companies may have to do less trimming of excess capacity and workers than they have done in recent recessions. Some companies are even expanding, albeit cautiously.
  
• While these trends don’t ensure a rapid recovery if the country falls into a recession, it does position companies to ride out the storm.

To read the full story, please click here: http://www.bloomberg.com/apps/news?pid=20601109&sid=ao6RcBfOUJz8&refer=home

Housing market continues plunge

Low-end houses slip; high-end ones stagnate

• April 15 provides an annual reminder about the tax benefits of owning a home: Most people know that mortgage interest and property taxes are deductible in most cases, as is the interest paid when homeowners borrow against the equity in their home. What they may not realize is that the Tax Payer Relief Act of 1997 provides that owners who have lived in their home for more than two years don’t have to pay taxes on the first $250,000 of profits (if they are single) and $500,000 of profits (if the owners are married) when they sell the home.
• Watch out for Generation Y prospects! The 2008 Swanepoel Trends Report notes that younger buyers represent a larger portion of the total home-buying population than ever before. Between 2003 and 2006, the percentage of under-30 homebuyers skyrocketed. Forty-two percent of the under-30 crowd reported owning a home, but what’s more surprising is that buyers under age 25 accounted for one-quarter of the home sales to this demographic group.
• The economy has replaced transportation as the San Francisco Bay Region’s most pressing problem for only the ninth time in 28 years, according to an annual survey conducted in early March by the Bay Area Council. Twenty-two percent of residents surveyed ranked the economy first, 18 percent said transportation was the biggest issue, and 15 percent cited housing as the region’s greatest challenge in this year’s poll. The economy was last cited as the greatest issue in 2003, but only 7 percent of those surveyed in 2006 ranked it at the top of their list, reflecting the top-of-mind nature of the current mortgage credit and economic situations. Despite economic concerns, Bay Area residents were relatively optimistic: 59 percent said their financial situation would be about the same as last year, with 30 percent saying they expect to do even better this year. Only 13 percent said they expect to be worse off. And 74 percent rated their quality of life in the Bay Area “very well” or “going somewhat well.”

To read the full article go to: http://www.insidebayarea.com/sanmateocountytimes/localnews/ci_8861454

Home Office....Can You Deduct on Your Taxes

This article is by CRS instructor, Chris Byrd who is well known for his tax strategy seminars. He has been a speaker for the Northern CA CRS Chapter and we find him to be very good! Chris@ChrisBirdSeminars.com or http://www/.chrisbirdseminars.com

Qualifying for the Home Office Deduction
The deduction allows you to deduct a pro-rata portion of your residential costs as a business expense when it's used as your principal place of business. The percentage of allowable expense (found by dividing the square footage of the office by the home's total square footage) can be applied to mortgage interest, insurance, property tax, rent, depreciation, utilities, and other home-related expenses.

The two requirements:

1. The space is exclusively used for business

2. You must regularly conduct some kind of business activity in the space

The home office deduction can only be taken if a portion of the home is used "exclusively and primarily" for business. That means the designated space cannot be used for any other purpose, like a guest room.

Although the space must be "separately identifiable," it needn't be blocked off with a permanent partition. This deduction can also apply to a separate structure not attached to the dwelling unit.

Your Home Office Needs to be Your Principal Place of Business
More taxpayers qualify since the definition of "principal place of business" was broadened to include a place where administrative or management activities are conducted on a substantial basis, if there is no other fixed location where they conduct substantial administrative or management activities (Taxpayer Relief Act of 1997). In short, this means that a self-employed person needs to spend more time running their business from home, not the brokerage sales office.

In my experience, real estate agents often fail to qualify for this deduction because they already have a brokerage sales office, where most of their activities in running their business are conducted.

Also, if you are an employee who works at home, the rules state that the home office must be for your employer's convenience, rather than your own. As popular as tele-commuting has become, make sure this point is clarified with your employer. That way you can document that the office space is specifically required by them.

One caveat for anyone taking this deduction. It cannot be taken for any year when the amount claimed will generate a net loss for the business. However, the untaken deduction can be carried forward to a year when there is sufficient profit to avoid that limitation.

Selling a Residence with a Home Office
In December, 2002, the US Treasury approved a change that removed a major negative for those who'd been taking the home office deduction. (And for those who feared taking it.) Normally, gain on the sale of a principal residence (where you resided two or more years) is tax free. Until that change, homeowners who sold would owe tax on the gain allocated to the office portion of their home.

The new Treasury rules change mean that a seller must no longer allocate the amount of gain between their business and personal use. The home office had to be within the house, however. And the new rules don't excuse any depreciation recapture that may have been taken for the home office.

Make Your House "Pay its Way"
Whether taking the home office deduction is tax-wise depends on your circumstances. Study the details in IRS Publication 587 http://www.irs.gov/publications/p587/Here's a tax strategy that every self-employed person should reconsider. Especially since several of the "traps" regarding the home-office deduction have been dismantled. Its tax advantages are substantial and could bring you significant savings-year after year

As always, please always consult withe your CPA or tax person regarding tax advice!

Just vapors and where did that gas go!

Here is some tips on how to save Gas from a friend......

TIPS ON PUMPING GAS I don't know what you guys are paying for gasoline.... but here in California we are also paying higher, up to $3.50 per gallon. But my line of work is in petroleum for about 31 years now, so here are some tricks to get more of your money's worth for every gallon..

Here at the Kinder Morgan Pipeline where I work in San Jose , CA we deliver about 4 million gallons in a 24-hour period thru the pipeline. One day is diesel the next day is jet fuel, and gasoline, regular and premium grades. We have 34-storage tanks here with a total capacity of 16,800,000 gallons.

Only buy or fill up your car or truck in the early morning when the ground temperature is still cold. Remember that all service stations have their storage tanks buried below ground. The colder the ground the more dense the gasoline, when it gets warmer gasoline expands, so buying in the afternoon or in the evening....your gallon is not exactly a gallon. In the petroleum business, the specific gravity and the temperature of the gasoline, diesel and jet fuel, ethanol and other petroleum products plays an important role. A 1-degree rise in temperature is a big deal for this business. But the service stations do not have temperature compensation at the pumps.

When you're filling up do not squeeze the trigger of the nozzle to a fast mode. If you look you will see that the trigger has three (3) stages: low, middle, and high. In slow mode you should be pumping on low speed, ther eby mi nimizing the vapors that are created while you are pumping. All hoses at the pump have a vapor return. If you are pumping on the fast rate, some of the liquid that goes to your tank becomes vapor. Those vapors are being sucked up and back into the underground storage tank so you're getting less worth for your money.

One of the most important tips is to fill up when your gas tank is HALF FULL or HALF EMPTY. The reason for this is, the more gas you have in your tank the less air occupying its empty space. Gasoline evaporates faster than you can imagine. Gasoline storage tanks have an internal floating roof. This roof serves as zero clearance between the gas and the atmosphere, so it minimizes the evaporation. Unlike service stations, here where I work, every truck that we load is temperature compensated so that every gallon is actually the exact amount.

**Another reminder, if there is a gasoline truck pumping into the storage tanks when you stop to buy gas, DO NOT fill up--most likely the gasoline is being stirred up as the gas is being delivered, and you might pick up some of the dirt that normally settles on the bottom.

Hope this will help you get the most value for your money. Here is a link to check where to find inexpensive/cheap gas. http://autos.msn.com/everyday/gasstations.aspx?zip&src=Netx

DO SHARE THESE TIPS WITH OTHERS!

**(It always felt like the gas lasted longer if it was above ½ a tank!!!)

The Housing Market is Fine, It's the High Cost of Oil that is messing us all up!

I read an article today by Linda Tremblay that I wanted to pass along that says alot about our market.

Everywhere you go, the news has been about foreclosures and the real estate market going downhill. I hate to tell the press, but if they would leave the housing market alone, we would be fine. Historically, the market has always had peaks and valleys. Along with this the press has send that home ownership is getting beyond our reach. As i have said before, I wish I would of bought about ten houses back then. If I sold them now, even at a reduced sale price now, I would be a millionaire.

The oil industry on the other hand is another story. The oil companies are making billions in profit as we are having to cut back on certain things to be able to drive our cars. That is bad enough and somehow we need to get away from depending on oil for our automobiles. But today I heard that the independent truckers are possibly going on strike because they can not afford the high cost of diesel. This weekend I saw regular gas at $3.15 and deisel was $4.20. Ouch!

Apparently it is costing the trucking industrymore money to run a load than they are making.
This is going to cause the price of everything to go up. Look at all the materials and food that is transported by the trucking industry. This is crazy. There ae so many smart people out there, hopefully someone can come up with an alternative method to run our trucks, our homes and our cars. After all, we can send a man to the moon.