The advantages of starting a home based business outweigh the time and small expense involved in setting up a viable business. For the long term, the overhead costs for starting a business in your home are very low. The government provides several tax incentives for individuals who have businesses set up in their home. There are some strict rules and regulations that must be met to qualify for the home-based business deduction but once confirmed, the tax refunds for having a home based business are very lucrative.In addition to the tax advantages, home based business owners have no daily transportation expenses. home based business owner has unlimited flexibility in balancing work and family commitments. Using technology for communication and business processes makes working from home a sensible and practical solution to the high price of gasoline, commuting time and costs of buying new clothes.Home-based businesses play a crucial role in the free enterprise system. These entrepreneurs contribute to the overall economy as well as the financial viability of their families. The ultimate dream of a home based business is to provide financial independence for the owner, their family and the community at large..Some of the most widely recognized software retailers and cosmetic companies had their beginning in a garage. Companies like Apple Computer, Hewlett Packard, Dell, Microsoft, Lotus and even the cosmetic giant, Mary Kay, were initially started as home based business enterprises.But, like any other type of business, a home-based business requires initial preparation, start-up capital, registration and ongoing marketing. Home based business are traditionally set up as a sole proprietorship. The home based business owner has to be an expert in all phases of the business. At some time in the business start up process, the home based business owner must know the details of the operational, strategic, legal, financial and marketing concerns.The following checklist covers the essential points to help you stay focused so that you can set up your own home-based business.Plan to SucceedEvery business needs to create a comprehensive business plan. The business plan will focus your efforts from selecting a product to sell all the way to the actual marketing of the product. This plan will cause ideas to generate and perhaps new methods of distribution for your business.The basic business plan contains a, executive summary, mission statement, marketing plans and profits that you want to achieve. The business plan is the blueprint that will guide you to your desired results. It is of utmost importance to prepare a draft of your business plan. The business plan will keep you on focused on your goals. If you intend to seek any type of funding for your business, it is imperative that a business plan is part of the start-up process.Selecting the Business StructureThe selection of your long term goals for your business will determine which structure you chose for your business. The choices include:o Sole Proprietorship
o Partnership
o CorporationThere are several different types of Corporation structures that you can choose. There are specific tax implications for each of the choices listed. Deciding on the business structure for your home based business enterprise is perhaps one of the most critical decisions you will make.You can search online to find out the specific requirements for each of the business structures listed. Your decision will have far-reaching consequences and will depend on important factors like capital, ability to do business in specific locations and the type of your business you are starting.To register or not to register?It is important for all legitimate business to register their business name. For tax and other proprietary purposes you should secure all necessary business licenses. Registering your business protects the name of your business. It is also important to become aware of the compliance requirements in your area. Local zoning regulations should be acquired to assure you that the business does not contravene local zoning laws.Insurance for Your Business?It is just smart to purchase insurance for your new business if you need to acquire financing. Business insurance is a prerequisite of lending institutions in case you plan to borrow money for your startup operations For online businesses that do not sell physical products, having insurance is a choice.Purchase Equipments Remember to keep all of your receipts when you purchase any office equipments or supplies. Your new computer, fax, printer, cell phone stationary supplies, and business cards are necessary business tools and are all tax deductible for your new business.Time ManagementHome-based entrepreneurs also require better time management skills than a corporate employee. Home based business owners must learn how to leverage their time and money. It is easy to get off track when your office is located in your garage, a den or the basement. Decide how much time you will devote to your business each day and stick to your time schedule.Automate as much of your business as possible so that you are always available to your customers. Schedule each phase of your business day and set up systems that will automatically reply to inquiries. Automation of your menial tasks is a critical element in your overall time management strategy.Web SiteBusinesses are longer restricted to brick and mortar locations. There are no limits to the number of customers that home based business owners can acquire. The home based business owner can no longer limit themselves to doing business in their local community. The Internet allows global business interaction from anywhere in the world. Having one website may not be sufficient to accomplish the level of success that a home based business owner requires.Home-based businesses compensate for their lack of a physical presence with a virtual presence in the World Wide Web. This presence may take the shape of several websites on several domains.Organization & AutomationTo conduct business in a professional and efficient way, it is important to organize everyday tasks into simple automated processes. Your home office should include everything you need to complete a transaction. It is easier to stay on top of daily tasks when the work-space is well organized. It is so much easier to complete the daily grunt work when these menial tasks are automated.Inventory and SuppliesFor home based business owners who sell physical products, it is important that these products are kept in a specified location. If you use your garage to keep stock you need to know the exact dimensions of your garage that is designated for this purpose. The best way to handle stock is to have the company send and maintain the bulk of your inventory. This eliminates a time lag for your customers. If you sell digital products, this process is handled automatically.Open the Door and Let Business BeginYou are now ready to open the virtual doors of your home based business to the global community. You have completed all the steps to insure that your business will be successful. You have a product, a website that allows you into the global marketplace.
There is an excessive amount of traffic coming from your Region.
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Investigating Health Care Fraud
Investigations relating to health care fraud activity are reportedly at an all time high, and will continue to flourish with the advent of new working groups, task forces and other fraud-fighting activity that existence depends on the development and investigation of health care fraud cases. Simply put, the investigation of health care fraud consists of proving that the provider engaged in an intentional deception or misrepresentation (of material fact) that resulted, or could have resulted, in an unauthorized payment. Some key facts related to health care fraud investigations:Complaint Driven: Private, local, state and/or federal agencies are actively involved in the identification and investigation of health care fraud and abuse, which, for the most part, are initiated by complaints received from patients, insurers and others on a health care provider or entity.Complaint Evaluation: The investigative process starts by the investigator evaluating the information in the complaint to determine if it represents actual misconduct, and then to identify what specific laws, rules, and/or regulations may have been violated. Critical areas to be addressed may include:oDOCUMENTATION-was the services documented as medically necessary, and completely and accurately documented in the patient’s health care record?oREGULATORY LAWS & RULES-were the services rendered consistent with the administrative law for the State, including scope of practice, training, supervision and delegation? Additionally, were the services, or the manner in which they were rendered, in violation of prohibited conduct?oTHIRD PARTY PAYER RULES-were the services rendered consistent with the rules set by the involved third party payer, including those relevant to limitation of services rendered, and those limiting the service provider?oCODING-were the proper ICD-9 and CPT-4 codes used to identify the condition (s) being treated and the services rendered when seeking reimbursement?Investigative Plan: The investigator will identify potential witnesses to interview, other needed information, such as patient and insurance claim files that may possess evidence of the misconduct. The successful investigation will result in the collection identify and collect all relevant evidence that would indicate the laws, rules and/or regulations governing health care have been violated, and to identify storytellers who will be able to testify on matters relevant to the identified misconduct. The patient file is the crime scene when investigating health care fraud & abuse.MAJOR TRENDS IN HEALTH CARE FRAUDProblem (Multidiscipline Practices): Some multidiscipline practices of medical doctors, chiropractors, and other providers working together in one practice entity are formed by some chiropractors as a means to circumvent managed care and other third party payer limitations on reimbursement of chiropractic services. At times, when necessary, multiple corporations are created to allow the chiropractor to employ medical doctors and to maintain control over all revenues of the multidiscipline practice. The services rendered by the chiropractor in cases where there is little or no chiropractic coverage are billed to the third party payer under the license and name of the medical doctor, purportedly following “Incident-to” billing principles after the medical doctor evaluated the patient and referred them for care with the chiropractor. Is the chiropractor billing for their services rendered under the license of a medical doctor?Problem (Mobile Labs): Some external companies, or mobile labs, market their electro-diagnostic testing services extensively to health care providers as a means to increase patient retention and increase revenues. The mobile lab provides on-site electro-diagnostic testing on the provider’s patients with their equipment and by their technician. The provider pays the lab a rental fee for the equipment and technician, and agrees to provide a minimum number of patients for testing during one day. The lab bills the third party payer for only the reading of the tests, or the professional component, and the provider bills for administering the tests, or the technical component, because they rented the equipment/technician and supervised its administration. Further, the lab will provide the provider with the CPT codes and amounts that should be reported and billed for the technical portion of the test. The provider, claiming to have supervised the administration of the diagnostic test, may not have the requisite training and skill on the test. Often, the total amount billed (both professional and technical) for the tests will far exceed the RVU (Relative Value Unit) set for these tests. The client provider usually will have no actual knowledge on what the labs will bill to the third party payer. What service did the provider perform to bill for the technical portion?Problem (Rehab): Some providers implement (active) rehabilitation care into their health care practices by having their unlicensed staff administer therapeutic procedures to patients that are defined as one-on-one with the patient by a licensed provider, and are reported in 15-minute increments. Documentation of medical necessity of therapeutic procedures may not be properly established in the patient’s clinical record as part of a treatment plan. Documentation of procedures in file, even when directly provided by licensed provider, may not be properly documented to account for the time component of the service, i.e., Start & End time, which includes pre-intra-post service time. Is the provider’s unlicensed staff rendering the rehab services to the patients of the practice? What does the patient’s health care record show? Do they support the need and accuracy of the billings?Problem (Billing): Various insurance companies have limitations on what health care conditions and services they will reimburse providers for. Some providers provide their patients with health care services that are not reimbursable by the involved managed care organization or third party payer, but report and bill for these services via use of ICD-9 and CPT-4 codes that are reimbursable. Some providers provide their patients with various health care services based solely on the premise that the involved managed care organization or third party payer will reimburse for those services.Problem (Solicitation): A number of providers market “free” services, such as consults, exams and x-rays to attract new patients that may not be established as medically necessary, or will later be billed to a third party payer. A number of providers’ market “free” services, such as therapeutic massage, as a means to attract new patients to the health care practice, which later may become a part of the patient’s billed care. A number of providers inform marketed individuals when converting them to patients that they will not be responsible for what the insurance company does not pay. For the health care provider what is a consult? Isn’t it a history? Was the promised free service, or a portion of it, later billed? Is it possible to give away a therapeutic massage without first examining the patient to establish need?