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Episode 502 features Stacey's conversation with Brian Machut (Alliant Health) on how widespread Medicare fee-for-service fraud is inflating costs and undermining ACO shared savings in MSSP and ACO REACH. ACOs uncovered major urinary catheter fraud in 2023 tied to codes A4352/A4353, totaling about $3.5B, with some beneficiaries billed for items never received (including a case shared by Dr. Tara Lagu). CMS created a "SAHS" (significant, anomalous, highly suspect) process to remove certain suspect costs, but benchmark effects can unevenly impact ACOs; catheter fraud is still projected at $3–$3.5B in 2025. The episode also highlights rapidly growing "skin substitute" spending projected at $13–$15B in 2025; CMS did not classify 2024 skin substitute costs as SAHS, leaving them in ACO performance calculations. Machut explains this fraud and missed CMS trend projections can reduce provider earnings, discourage participation in value-based care, and potentially drive cost shifting into higher commercial rates—affecting plan sponsors such as self-insured employers. === LINKS ===
Ken Landau talks with Attorney Rosa M. Feeney, a partner and chair of the insurance risk division of the Smiley and Smiley Law Firm, who describes "Resolving Insurance Coverage Disputes." Sometimes the insurance company denies coverage after a possible claim for compensation or protection after an accident or event, so find out the steps the individual or company can take to litigate the claim and receive compensation or protection under an insurance policy.
Ken Landau talks with Attorney Rosa M. Feeney, a partner and chair of the insurance risk division of the Smiley and Smiley Law Firm, who describes how to "Protect Yourself with Insurance." She outlines the different types of insurance a student, family or business may need; and how it might protect them if there is a lawsuit or judgment; or provide compensation for them after an accident. She also explains what to do after an accident or possible claim.
Pool Pros text questions hereIn this episode of the Talking Pools podcast, host Steve Sherwood and guest Pat Grenon discuss various aspects of pool services, including subcontracting, insurance considerations, the importance of technology in efficiency, pricing strategies, and the significance of proper testing and chemical management in pool maintenance. They emphasize the need for pool professionals to adapt to changing market conditions and to ensure they are providing quality service while maintaining profitability.takeawaysSubcontracting can enhance service quality and efficiency.Being added as an additional insured protects your business.Utilizing technology like Google Earth can save time and money.Regularly review and adjust pricing to reflect rising costs.Understanding pool size and chemical needs is crucial for profitability.Testing water quality accurately is essential for client satisfaction.Maintaining clear communication with clients can prevent misunderstandings.Investing in robotic vacuums can improve service quality.Tracking profit and loss helps identify unprofitable clients.Continuous education and adaptation are key in the pool service industry.titlesNavigating the Pool Service IndustrySubcontracting: A Key to EfficiencySound Bites"It's a protective mechanism.""Time and money, right?""You need to track your profit and loss."Chapters00:00Introduction to Pool Business Insights02:22Navigating Subcontractor Relationships08:38Understanding Insurance and Liability12:45Maximizing Efficiency with Technology26:31Pricing Strategies and Cost Management33:02Chemical Management and Testing Best Practices LaMotte CompanyLaMotte Company is a leading manufacturer of water quality testing products & pool test kitsCalifornia Pool AssociationPool Industry Trade OrganizationCMAHCThe Council for the Model Aquatic Health Code promotes health & safety at public swimming poolsDisclaimer: This post contains affiliate links. If you make a purchase, I may receive a commission at no extra cost to you.Support the showThank you so much for listening! You can find us on social media: Facebook Instagram Tik Tok Email us: talkingpools@gmail.com
This time on Code WACK! Why are people in America resorting to receiving medical care in animal stalls - even if they have health insurance? What would it take to make volunteer stopgap clinics unnecessary - and who stands in the way of real reform? To break it down, we spoke with leading healthcare reform advocate and New York Times bestselling author Wendell Potter. A former health insurance executive turned industry whistleblower, Wendell now serves as board president of the Center for Health and Democracy, which advocates for healthcare reform, and editor-in-chief of HEALTHCARE Un-covered, which investigates healthcare corporations and insurance conglomerates. This is part two of a two-part series. Check out the Transcript and Show Notes for more! Keep Code WACK! on the air with a tax-deductible donation at heal-ca.org/donate.
Paul Kavanagh from McCarthy Insurance looks at clauses that might catch you and as the system is mostly automatic now so it pays to be careful he tells PJ Hosted on Acast. See acast.com/privacy for more information.
This time on Code WACK! Why are people in America resorting to receiving medical care in animal stalls - even if they have health insurance? What would it take to make volunteer stopgap clinics unnecessary - and who stands in the way of real reform? To break it down, we spoke with leading healthcare reform advocate and New York Times bestselling author Wendell Potter. A former health insurance executive turned industry whistleblower, Wendell now serves as board president of the Center for Health and Democracy, which advocates for healthcare reform, and editor-in-chief of HEALTHCARE Un-covered, which investigates healthcare corporations and insurance conglomerates. This is part two of a two-part series. Check out the Transcript and Show Notes for more!
This time on Code WACK! Why are people in America resorting to receiving medical care in animal stalls - even if they have health insurance? What would it take to make volunteer stopgap clinics unnecessary - and who stands in the way of real reform? To break it down, we spoke with leading healthcare reform advocate and New York Times bestselling author Wendell Potter. A former health insurance executive turned industry whistleblower, Wendell now serves as board president of the Center for Health and Democracy, which advocates for healthcare reform, and editor-in-chief of HEALTHCARE Un-covered, which investigates healthcare corporations and insurance conglomerates. This is part two of a two-part series. Check out the Transcript and Show Notes for more!
Hello, all you and the Relentless Health Tribe trying to figure out how to do right by patients and the folks footing the bill. Welcome to it. This is episode 499, one episode before episode 500. So, come back next week for that one. For a full transcript of this episode, click here. If you enjoy this podcast, be sure to subscribe to the free weekly newsletter to be a member of the Relentless Tribe. All right, so today, let's talk about the inches that are all around us. Let's find some. Musculoskeletal spend, otherwise known as MSK spend, for any given plan sponsor adds up to the tune of something like 20% or 30% of total plan spending, depending on the member demographic. MSK rolls in at $16 PMPM, I just saw, according to a report Keith Passwater sent me a couple of weeks ago. It's the third most costly spend apparently overall. And it's easy to see why, right? On any given day, odds are good any given plan member is gonna do something that, in hindsight, was fairly obviously a bad idea and wind up getting hurt in some low-acuity way. For example, I remember that one time I twisted my ankle on a curb getting outta my car. Given the right space, enough time, and concentration, I can do the worst parking job you've ever seen in your life and manage to twist my ankle in the process. But I digress. Here's the point. MSK spend adds up really fast. Add to that something like 50% of spine surgeries are said to be unnecessary. The same thing goes true from injuries like twisted ankles, for example, that would have healed themselves without an ER visit, without any intervention aside from ice, rest, and elevate. Because it turns out that something like 80% of those twisted-ankle, banged-up-the-back types of MSK injuries are actually low acuity, and a huge percentage of those will heal by themselves. On that point, let me bring in some context here, some late-breaking news. I was reading Dana Prommel's newsletter. She wrote, and I'm reading this, she wrote, "The 2026 National Healthcare Expenditure data reports are out, and it is another sobering reflection of our current system. Personal healthcare spending has surged by over 8%, and our healthcare spend as a share of the GDP has followed that same aggressive trajectory." Then Dana writes, "The most troubling takeaway from the 2026 report is the lack of a 'health dividend.' Despite [this] 8% increase in spending, we aren't seeing a corresponding 8% increase in longevity, wellness, or chronic disease management. People aren't getting significantly healthier; they are just getting more 'care.' And that 'care' isn't always good care, or the right care, or care by the right type of clinician, at the right time, in the right setting." Is that not the perfect segue or what? Because this is what we're talking about on the show today in regard to, again, MSK care—care that can wind up costing millions of dollars across plan members, and it might be unnecessary because, again, the twisted ankle or the pain in the lower back would have healed itself without any care, without an ER visit. But if an ER visit was had, that patient probably is gonna wind up with a bunch of imaging. Probably is gonna wind up with a referral to a surgeon. And now there's a surgery scheduled, and the patient has been off work for however long all that took. There's a lot of direct and indirect costs that may or may not add up to any given health dividend or health span or whatever you wanna call it—better quality of life. Why does all this happen? How does it happen? One reason is what Dr. Jay Kimmel calls the white space of MSK care. This is where a patient does a truly breathtaking job parking the car, twists her ankle, starts to swell up, and now a decision has to be made: Go to the ER. Go to urgent care. Go home. Or what if it's a parent making this choice for a kid? In the olden days, maybe that patient would've called up his or her longtime family doctor and asked what to do, and maybe if that longtime family doctor didn't know, he or she would have called up the local ortho and gotten their opinion. Or maybe the two were sitting together in the doctor's lounge at the time, or maybe they rounded together in the hospital and, and, and … There used to be lots of opportunities for spontaneous questions and answers and curbside consults. But not today most of the time, really, unless you're a patient with a doctor in the family. But even for a PCP, who wants an ortho consult? Amy Scanlan, MD, and I discussed this quite a bit in an earlier episode (EP402). There's no doctor lounges anymore. There's no coffee klatch down in radiology either. There's just a lot of cultural shifts, in other words. But all of this, everything I have said thus far, all adds up to one big takeaway: These excess costs that don't have commensurate improved clinical outcomes, they happen because patients are on their own to triage themselves. They look at their black-and-blue whatever, or they're standing there listening to their kid cry and they are deciding what to do. And the thing is, if they choose the ER—because, again, they don't have a doctor, anybody they can just call with the right kind of clinical background—once they head into that ER and sit there for six hours and demand an MRI because now it has to be worth their time because they sat there for six hours; but now there's a false positive and the ER docs are being conservative because of malpractice or whatever and they refer them to some sort of surgeon … Look, everybody's doing their best with the information that they have at the time, but you can see how easy it is for a person to avoidably wind up costing a lot of money for a musculoskeletal injury that would have healed by itself. So, yeah, let's talk about how we can get patients some help in that so-called white space. How can we get them, triage before the triage, as I managed to say more than once in the conversation that follows? Let's get them on a good trajectory to start. Today, my guest is Dr. Jay Kimmel. Dr. Kimmel is an orthopedic surgeon, and he's been in practice in Connecticut for over 35 years. He and Steve Schutzer, MD, co-founded Upswing Health. I talked with Dr. Steve Schutzer about Centers of Excellence in an earlier episode (EP294). Upswing Health provides members with the opportunity to talk with an athletic trainer within 15 minutes and an orthopedic specialist within 24 hours. So, instead of having a panic attack of indecision and ultimately winding up in the ER, getting coughed on in the waiting room, members have somebody helping them in this white space so they can get triaged before the triage. I need to thank Upswing Health. I am so appreciative they donated some financial support to cover the costs of this episode. This podcast is sponsored by Aventria Health Group with an assist from Upswing Health. Also mentioned in this episode are Upswing Health; Keith Passwater; Dana Prommel; Amy Scanlan, MD; Steve Schutzer, MD; Eric Bricker, MD; Al Lewis; Nikki King, DHA; Matt McQuide; Christine Hale, MD, MBA; and Chris Deacon. For a list of healthcare industry acronyms and terms that may be unfamiliar to you, click here. You can learn more at upswinghealth.com and follow Dr. Kimmel on LinkedIn. Jay Kimmel, MD, is the president and co-founder of Upswing Health, the country's first virtual orthopedic clinic. He founded Upswing with Steve Schutzer, MD, to rapidly assess, triage, and manage orthopedic conditions in a cost-effective, high-value manner, helping patients avoid unnecessary imaging, procedures, and delays in care. Dr. Kimmel had a long and distinguished career as a practicing orthopedic surgeon with Advanced Orthopedics New England. He earned his undergraduate degree from Cornell University and his medical degree from the University of Rochester. He completed his orthopedic residency at Columbia Presbyterian Medical Center, where he trained with leaders in shoulder surgery, followed by a sports medicine fellowship at Temple University Center for Sports Medicine, where he participated in the care of Division I collegiate athletes. He is board-certified in orthopedic surgery and is a Fellow of the American Academy of Orthopedic Surgeons. Dr. Kimmel specializes in sports medicine with an emphasis on shoulder and knee injuries and holds a subspecialty certificate in orthopedic sports medicine from the American Board of Orthopedic Surgery. He is also a member of the American Orthopedic Society for Sports Medicine. Dr. Kimmel co-founded the Connecticut Sports Medicine Institute at Saint Francis Hospital, a multidisciplinary center dedicated to providing high-quality care for athletes at all levels, and served as its co-director for many years. He has a strong commitment to education and served for over 20 years as an assistant clinical professor in both family medicine and orthopedics at the University of Connecticut. He has also served as a team physician at the professional, collegiate, and high school levels. 07:49 EP472 with Eric Bricker, MD, on high-cost claimants. 08:01 What is the "white space" in MSK spend? 10:43 Statistics on Connecticut's spending on plan members with low-acuity MSK injuries. 13:30 How back pain also easily transitions from a low-acuity issue to a high-acuity problem. 15:11 How plan sponsors can detect their white space downstream spend. 16:58 EP464 with Al Lewis. 17:02 EP470 with Nikki King, DHA. 18:15 Why where patients start their journey often dictates where they wind up and how costly that medical pathway is. 20:48 Where PCPs fit into this MSK spend issue. 25:26 EP468 with Matt McQuide. 25:34 EP471 with Christine Hale, MD, MBA. 25:39 Why access is key. You can learn more at upswinghealth.com and follow Dr. Kimmel on LinkedIn. Jay Kimmel, MD, of @upswinghealth discusses #MSKspend on our #healthcarepodcast. #healthcare #podcast #financialhealth #patientoutcomes #primarycare #digitalhealth #healthcareleadership #healthcaretransformation #healthcareinnovation #musculoskeletal Recent past interviews: Click a guest's name for their latest RHV episode! Mark Noel, Gary Campbell (Take Two: EP341), Zack Kanter, Mark Newman, Stacey Richter (INBW45), Stacey Richter (INBW44), Marilyn Bartlett (Encore! EP450), Dr Mick Connors
My dearest TFD Baddies,It's been a little bit. But I come to you with important information. Links as promised:https://secure.money.com/pr/se78f4e9a300https://secure.money.com/pr/qe5c0a8a5bcbLove,Stephanie xoxox This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit thefinancediaries.substack.com
Carl Quintanilla, Sara Eisen, and David Faber kicked off the hour with a fresh debate around the latest trade headlines - before Apollo Chief Economist Torsten Slok broke down what it all means for stocks. At the bottom of the S&P? Health insurance stocks... sliding on a new medicare proposal out of the White House. Hear more from one analyst who says to buy the dip here. Also: a multitude of A.I. headlines - as one key CEO pens a fresh warning for humanity, Meta signs a new deal with Corning sending those shares surging, and investors eye Chinese competition (on the 1-year anniversary of the DeepSeek related sell-off). A.I. expert X. Eyeé joined the team with a deep-dive on all of it. Squawk on the Street Disclaimer Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.
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Sod's Country Farms was raising 65,000 chickens when a fire burned down the poultry house. After a detailed investigation, the cause of the fire was undetermined. To further complicate matters, Sod's Country Farms didn't even own the chickens themselves, but raised them for a vendor. They want to know if the property loss of the animals is covered-- and what policy would be most appropriate. Notable Timestamps [ 00:00 ] - A poultry house fire destroys 65,000 chickens, but the insured doesn't own the birds. [ 03:30 ] - Contract Growing is common in agriculture, with farmers raising animals owned by vendors. [ 05:20 ] - Under the ISO BOP, animals are generally excluded, but exceptions exist for animals owned by others and "boarded" by the insured. [ 07:00 ] - Courts may rely on dictionary definitions when policy terms like "boarded" are undefined. [ 09:00 ] - Adjusters should review the contract for risk transfer provisions, insurance requirements, and other-insurance clauses to understand responsibilities and potential overlap. [ 11:30 ] - Standard BOP coverage can fall short for farming operations. Specialized farm policies are designed to address poultry risks more directly through scheduling and declaration-based coverage. [ 13:30 ] - Declarations pages matter in agricultural losses. How buildings, poultry locations, and coverage types are defined can determine whether coverage applies or is excluded. [ 15:30 ] - Valuing large-scale poultry losses is complex, involving age, weight, market timing, pricing data, and delay to market, often guided by specific policy language on cash market value. [ 17:15 ] - Brennan summarizes the key points above. Your PLRB Resources Annotation: BP191 - Animals - https://members.plrb.org/documents/bp191-animals Podcast Episode: Don't Count Your Chicken Coops Before They're Insured - https://members.plrb.org/education/courses/dont-count-your-chicken-coops-before-theyre-insured Listeners can email education@plrb.org for help navigating resources, requesting new content, or getting tailored curriculum support. Employees of member companies also have access to a searchable legal database, hundreds of hours of video trainings, building code materials, weather data, and even the ability to have your coverage questions answered by our team of attorneys (https://www.plrb.org/ask-plrb/) at no additional charge to you or your company. Subscribe to this Podcast Your Podcast App - Please subscribe and rate us on your favorite podcast app YouTube - Please like and subscribe at @plrb LinkedIN - Please follow at "Property and Liability Resource Bureau" Send us your Scenario! Please reach out to us at 630-509-8704 with your scenario! This could be your "adjuster story" sharing a situation from your claims experience, or a burning question you would like the team to answer. In any case, please omit any personal information as we will anonymize your story before we share. Just reach out to scenario@plrb.org. Legal Information The views and opinions expressed in this resource are those of the individual speaker and not necessarily those of the Property & Liability Resource Bureau (PLRB), its membership, or any organization with which the presenter is employed or affiliated. The information, ideas, and opinions are presented as information only and not as legal advice or offers of representation. Individual policy language and state laws vary, and listeners should rely on guidance from their companies and counsel as appropriate. Music: "Piece of Future" by Keyframe_Audio. Pixabay. Pixabay License. Font: Metropolis by Chris Simpson. SIL OFL 1.1. Icons: FontAwesome (SIL OFL 1.1) and Noun Project (royalty-free licenses purchased via subscription). Sound Effects: Pixabay (Pixabay License) and Freesound.org (CC0).
Dr. Kumar Dharmarajan, cardiologist and geriatrician and Co-Founder and Chief Medical Officer at World Class Health, is bringing concierge healthcare to employees of self-insured companies. The platform includes a global network of top-tier doctors and nurse navigators. Directly negotiating with providers reduces costs and reduces administrative and financial friction for patients seeking planned procedures. The model also reduces friction for physicians by providing them with complete patient records and ensuring prompt payment. Kumar explains, "We are a global, medically led center of excellence platform. So, by that, we have top doctors and top hospitals around the world, including the United States and many other countries, and we help patients access that network. We have pre-negotiated rates via our nurse navigators. We really believe in the power of nurses to help patients make healthcare decisions that may be valuable and important to them. And those nurses will work with the patient before, during, and after their care episode, whether that physician they access is local, in their own communities, or somewhere else around the world. And right now, we are partnering with large self-insured companies around the world and offering our product, in addition to the network they have through their usual insurer." "We are looking for employees of self-insured large companies. Our specific target has been largely knowledge workers, so these are employees in technology, financial services, and other knowledge industries. And the reason we feel that is one, our global network may be really appealing to them because many knowledge workers come from different parts of the world, Asia, Europe, Latin America, etc. And second, our nurses and our strong concierge model, which we built with experts from Stanford and Johns Hopkins International, have created a truly white-glove experience. So not only are they high-quality, highly qualified providers, top 1% doctors, hospitals around the world, but it's also a white glove service to help patients deal with all the administrative minutiae and challenges we all experience in healthcare. And we believe that's well powered and tailored to the knowledge industry." #WorldClassHealth #SelfInsured #ConciergeCare #NurseNavigators #DigitalHealth worldclasshealth.com Download the transcript here
Dr. Kumar Dharmarajan, cardiologist and geriatrician and Co-Founder and Chief Medical Officer at World Class Health, is bringing concierge healthcare to employees of self-insured companies. The platform includes a global network of top-tier doctors and nurse navigators. Directly negotiating with providers reduces costs and reduces administrative and financial friction for patients seeking planned procedures. The model also reduces friction for physicians by providing them with complete patient records and ensuring prompt payment. Kumar explains, "We are a global, medically led center of excellence platform. So, by that, we have top doctors and top hospitals around the world, including the United States and many other countries, and we help patients access that network. We have pre-negotiated rates via our nurse navigators. We really believe in the power of nurses to help patients make healthcare decisions that may be valuable and important to them. And those nurses will work with the patient before, during, and after their care episode, whether that physician they access is local, in their own communities, or somewhere else around the world. And right now, we are partnering with large self-insured companies around the world and offering our product, in addition to the network they have through their usual insurer." "We are looking for employees of self-insured large companies. Our specific target has been largely knowledge workers, so these are employees in technology, financial services, and other knowledge industries. And the reason we feel that is one, our global network may be really appealing to them because many knowledge workers come from different parts of the world, Asia, Europe, Latin America, etc. And second, our nurses and our strong concierge model, which we built with experts from Stanford and Johns Hopkins International, have created a truly white-glove experience. So not only are they high-quality, highly qualified providers, top 1% doctors, hospitals around the world, but it's also a white glove service to help patients deal with all the administrative minutiae and challenges we all experience in healthcare. And we believe that's well powered and tailored to the knowledge industry." #WorldClassHealth #SelfInsured #ConciergeCare #NurseNavigators #DigitalHealth worldclasshealth.com Listen to the podcast here
The Guidewire Connections event that happens every year is not just a celebration for the SaaS insurance software provider, it's a chance see the vision, and extended ecosystem of partners who make the value come alive. Curt Wyatt attended the event this year and was there when news broke, heard from partners about the future of service and value along with some interesting and perhaps more pragmatic takes on AI.In this episode:Joseph Desouza from Pro Navigator on merging with GuidewireHow claims tech is being powered by AI and the value insurers are seekingWhy document ingestion and managing unstructured data is becoming more of a priorityHear from partners who are helping Guidewire grow and deliver value by experienceThis episode is a compilation of thoughts from various people and sheds light on how key industry partners are working to deliver a bigger vision and better experience together.See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.
Sam is a huge Bears fan. He sets up his brand new smoker in the backyard and put a perfectly seasoned pork shoulder on to cook all day -- just in time for the Sunday Night Bears v. Packers game. The smoker was near the side of the house, but not directly next to it. After 8 hours, the shoulder was tender and ready to eat… but the insured's siding had melted. Sam seeks coverage for the replacement of the melted siding (and for the pork shoulder he dropped when he saw the damage). Notable Timestamps [ 00:23 ] - Sonia sets out a tragic game day scenario. [ 01:16 ] - Fire is often defined by courts using dictionary definitions, such as Merriam-Webster's: "the phenomenon of combustion manifested in light and heat". [ 04:38 ] - Scorching analysis suggests black marks may indicate oxidation and a glow (which could be fire damage), while brown marks often indicate high heat damage only. [ 06:58 ] - For insurance purposes, losses must be fortuitous; Sam was trying to smoke meat, not melt the siding, so the damage was fortuitous from his perspective. [ 08:37 ] - Most states rely on "proximate cause", i.e. the dominant or efficient cause that initiates the events, when analyzing causation for claims. [ 09:23 ] - Friendly fire is contained in its usual place (like a stove), while hostile fire is unexpected or uncontrolled and not in its intended location. However, this analysis is not typically used by modern courts. [ 11:43 ] - Sonia provides a recap of the points above. Your PLRB Resources The Future of Insurance Podcast - https://future-of-insurance.com/podcast/ Coverage Question: Smoker Melts Nearby Siding - https://www.plrb.org/documents/named-peril-coverage-smoker-melts-nearby-siding-pcq-2025-02-24-slc-a/ Coverage Question: Christmas Lights Scorched Couch: Is Couch Covered? - https://www.plrb.org/documents/fire-peril-scorched-couch/ Employees of member companies also have access to a searchable legal database, hundreds of hours of video trainings, building code materials, weather data, and even the ability to have your coverage questions answered by our team of attorneys (https://www.plrb.org/ask-plrb/) at no additional charge to you or your company. Subscribe to this Podcast Your Podcast App - Please subscribe and rate us on your favorite podcast app YouTube - Please like and subscribe at @plrb LinkedIN - Please follow at "Property and Liability Resource Bureau" Send us your Scenario! Please reach out to us at 630-509-8704 with your scenario! This could be your "adjuster story" sharing a situation from your claims experience, or a burning question you would like the team to answer. In any case, please omit any personal information as we will anonymize your story before we share. Just reach out to scenario@plrb.org. Legal Information The views and opinions expressed in this resource are those of the individual speaker and not necessarily those of the Property & Liability Resource Bureau (PLRB), its membership, or any organization with which the presenter is employed or affiliated. The information, ideas, and opinions are presented as information only and not as legal advice or offers of representation. Individual policy language and state laws vary, and listeners should rely on guidance from their companies and counsel as appropriate. Music: "Piece of Future" by Keyframe_Audio. Pixabay. Pixabay License. Font: Metropolis by Chris Simpson. SIL OFL 1.1. Icons: FontAwesome (SIL OFL 1.1) and Noun Project (royalty-free licenses purchased via subscription). Sound Effects: Pixabay (Pixabay License) and Freesound.org (CC0).
Nefertarei El Bey (Nef-er-tar-ee), a woman whose goal in life is to be integral and live a purpose-filled life. She worked in healthcare for over 23 years. Her past experiences prepared me for a variety of development and leadership. She has worn lots of hats: Insurance Claims Management, Customer Service Management, Medical Billing and Coding, Auditor for Subrogation Cases. The list goes on and on.The commonality of all these roles is people. Everyone wants to be heard and understood. All the roles she found herself in were liaisons between the company and the people. This is how she came to know my true purpose, being a servant to man.She is honored to be a community resource, helping individuals understand Medicare plans and final expenses. She's a licensed agent for health and life in 13 states. She is invested in each client by educating and keeping them informed of updates.Nefertarei is a wife, mother, grandma, sister, auntie, daughter, and most importantly, a child of God. She resides with her husband in Concord, NC. Her ideal weekend is not to have plans and do NOTHING!!! Nevertheless, when you hear her name or think of her now, she is passionate and always grateful to serve.Learn more: http://www.insuredbynef.com/Influential Entrepreneurs with Mike Saundershttps://businessinnovatorsradio.com/influential-entrepreneurs-with-mike-saunders/Source: https://businessinnovatorsradio.com/interview-with-nef-el-bey-with-c-k-healthcare-advisors-founder-of-insured-by-nef-discussing-legacy-protection
Nefertarei El Bey (Nef-er-tar-ee), a woman whose goal in life is to be integral and live a purpose-filled life. She worked in healthcare for over 23 years. Her past experiences prepared me for a variety of development and leadership. She has worn lots of hats: Insurance Claims Management, Customer Service Management, Medical Billing and Coding, Auditor for Subrogation Cases. The list goes on and on.The commonality of all these roles is people. Everyone wants to be heard and understood. All the roles she found herself in were liaisons between the company and the people. This is how she came to know my true purpose, being a servant to man.She is honored to be a community resource, helping individuals understand Medicare plans and final expenses. She's a licensed agent for health and life in 13 states. She is invested in each client by educating and keeping them informed of updates.Nefertarei is a wife, mother, grandma, sister, auntie, daughter, and most importantly, a child of God. She resides with her husband in Concord, NC. Her ideal weekend is not to have plans and do NOTHING!!! Nevertheless, when you hear her name or think of her now, she is passionate and always grateful to serve.Learn more: http://www.insuredbynef.com/Influential Entrepreneurs with Mike Saundershttps://businessinnovatorsradio.com/influential-entrepreneurs-with-mike-saunders/Source: https://businessinnovatorsradio.com/interview-with-nef-el-bey-with-c-k-healthcare-advisors-founder-of-insured-by-nef-discussing-legacy-protection
Send us a textOur Patreon - https://www.patreon.com/HockeyCardsGongshowOn this episode of the Hockey Cards Gongshow podcast we start with Phil's trip to Private Collection Insurance to get his PC covered (7:06). Then Ken Reid joins the show to talk about his new book The Next One, the current state of the hockey hobby and the start to the 2025-26 NHL season (31:16).Partners & SponsorsGongshow Reloaded - https://www.GongshowReloaded.comHockeyChecklists.com - https://www.hockeychecklists.comSlab Sharks Consignment - http://bit.ly/3GUvsxNSlab Sharks is now accepting U.S. submissions!MINTINK - https://www.mintink.caPSA - https://www.psacard.comGP Sports Cards - https://gpsportcards.com/Private Collection Insurance - https://privatecollectioninsurance.comSign up for Card Ladder - https://app.cardladder.com/signup?via=HCGongshoFollow Hockey Cards Gongshow on social mediaInstagram - https://www.instagram.com/hockey_cards_gongshow/TikTok - https://www.tiktok.com/@hockey_cards_gongshowFacebook - https://www.facebook.com/HockeyCardsGongshowTwitter - https://twitter.com/HCGongshowThe Hockey Cards Gongshow podcast is a production of Dollar Box Ventures LLC
Nefertarei El Bey (Nef-er-tar-ee), a woman whose goal in life is to be integral and live a purpose-filled life. She worked in healthcare for over 23 years. Her past experiences prepared me for a variety of development and leadership. She has worn lots of hats: Insurance Claims Management, Customer Service Management, Medical Billing and Coding, Auditor for Subrogation Cases. The list goes on and on.The commonality of all these roles is people. Everyone wants to be heard and understood. All the roles she found herself in were liaisons between the company and the people. This is how she came to know my true purpose, being a servant to man.She is honored to be a community resource, helping individuals understand Medicare plans and final expenses. She's a licensed agent for health and life in 13 states. She is invested in each client by educating and keeping them informed of updates.Nefertarei is a wife, mother, grandma, sister, auntie, daughter, and most importantly, a child of God. She resides with her husband in Concord, NC. Her ideal weekend is not to have plans and do NOTHING!!! Nevertheless, when you hear her name or think of her now, she is passionate and always grateful to serve.Learn more: http://www.insuredbynef.com/Influential Entrepreneurs with Mike Saundershttps://businessinnovatorsradio.com/influential-entrepreneurs-with-mike-saunders/Source: https://businessinnovatorsradio.com/interview-with-nef-el-bey-with-c-k-healthcare-advisors-founder-of-insured-by-nef-discussing-empowerment-through-opportunity-for-women-everywhere
Nefertarei El Bey (Nef-er-tar-ee), a woman whose goal in life is to be integral and live a purpose-filled life. She worked in healthcare for over 23 years. Her past experiences prepared me for a variety of development and leadership. She has worn lots of hats: Insurance Claims Management, Customer Service Management, Medical Billing and Coding, Auditor for Subrogation Cases. The list goes on and on.The commonality of all these roles is people. Everyone wants to be heard and understood. All the roles she found herself in were liaisons between the company and the people. This is how she came to know my true purpose, being a servant to man.She is honored to be a community resource, helping individuals understand Medicare plans and final expenses. She's a licensed agent for health and life in 13 states. She is invested in each client by educating and keeping them informed of updates.Nefertarei is a wife, mother, grandma, sister, auntie, daughter, and most importantly, a child of God. She resides with her husband in Concord, NC. Her ideal weekend is not to have plans and do NOTHING!!! Nevertheless, when you hear her name or think of her now, she is passionate and always grateful to serve.Learn more: http://www.insuredbynef.com/Influential Entrepreneurs with Mike Saundershttps://businessinnovatorsradio.com/influential-entrepreneurs-with-mike-saunders/Source: https://businessinnovatorsradio.com/interview-with-nef-el-bey-with-c-k-healthcare-advisors-founder-of-insured-by-nef-discussing-empowerment-through-opportunity-for-women-everywhere
Nefertarei El Bey (Nef-er-tar-ee), a woman whose goal in life is to be integral and live a purpose-filled life. She worked in healthcare for over 23 years. Her past experiences prepared me for a variety of development and leadership. She has worn lots of hats: Insurance Claims Management, Customer Service Management, Medical Billing and Coding, Auditor for Subrogation Cases. The list goes on and on.The commonality of all these roles is people. Everyone wants to be heard and understood. All the roles she found herself in were liaisons between the company and the people. This is how she came to know my true purpose, being a servant to man.She is honored to be a community resource, helping individuals understand Medicare plans and final expenses. She's a licensed agent for health and life in 13 states. She is invested in each client by educating and keeping them informed of updates.Nefertarei is a wife, mother, grandma, sister, auntie, daughter, and most importantly, a child of God. She resides with her husband in Concord, NC. Her ideal weekend is not to have plans and do NOTHING!!! Nevertheless, when you hear her name or think of her now, she is passionate and always grateful to serve.Learn more: http://www.insuredbynef.com/Influential Entrepreneurs with Mike Saundershttps://businessinnovatorsradio.com/influential-entrepreneurs-with-mike-saunders/Source: https://businessinnovatorsradio.com/interview-with-nef-el-bey-with-c-k-healthcare-advisors-founder-of-insured-by-nef-discussing-asset-management-for-the-working-class
Nefertarei El Bey (Nef-er-tar-ee), a woman whose goal in life is to be integral and live a purpose-filled life. She worked in healthcare for over 23 years. Her past experiences prepared me for a variety of development and leadership. She has worn lots of hats: Insurance Claims Management, Customer Service Management, Medical Billing and Coding, Auditor for Subrogation Cases. The list goes on and on.The commonality of all these roles is people. Everyone wants to be heard and understood. All the roles she found herself in were liaisons between the company and the people. This is how she came to know my true purpose, being a servant to man.She is honored to be a community resource, helping individuals understand Medicare plans and final expenses. She's a licensed agent for health and life in 13 states. She is invested in each client by educating and keeping them informed of updates.Nefertarei is a wife, mother, grandma, sister, auntie, daughter, and most importantly, a child of God. She resides with her husband in Concord, NC. Her ideal weekend is not to have plans and do NOTHING!!! Nevertheless, when you hear her name or think of her now, she is passionate and always grateful to serve.Learn more: http://www.insuredbynef.com/Influential Entrepreneurs with Mike Saundershttps://businessinnovatorsradio.com/influential-entrepreneurs-with-mike-saunders/Source: https://businessinnovatorsradio.com/interview-with-nef-el-bey-with-c-k-healthcare-advisors-founder-of-insured-by-nef-discussing-asset-management-for-the-working-class
Thousands of people are expected to gather across the Monterey Bay Area Saturday as part of nationwide “No Kings” protests. And, with monthly premiums for Affordable Care Act plans set to increase soon, KAZU wants to hear from local residents who get health insurance through Covered California.
In this third episode of our personal insurance series, Jess Brady unpacks Total and Permanent Disability (TPD) Insurance and dives into everything you need to know — including what it is, how it works, how much cover you might need and the real-life costs of living with a disability.Financially Fierce is proudly supported by Sphere Home Loans and Skye Wealth.Need a mortgage broker? Check out https://www.spherehomeloans.com.auNeed to review your personal insurances? Head to https://skye.com.auTo organise a clarity call chat with Jess, or to check out either The Evergreen Money Growing Club or The Greenhouse Money Growing Program, click here.Find Jess on socials! @jessbrady_financialadviceTo get help click here. Hosted on Acast. See acast.com/privacy for more information.
Bad Faith in Dealing with Insured I’m Katelyn Holub, an attorney focusing on personal injury law in northwest Indiana. Welcome to Personal Injury Primer, where we break down the law into simple terms, provide legal tips, and discuss personal injury law topics. In our last episode, we discussed the requirement that insurance policies in Indiana […] The post Ep 333 Bad Faith in Dealing with Insured first appeared on Personal Injury Primer.
Neal Shah's journey, showcases the impact of caregiving on individual lives and the broader healthcare system. Raised in a close-knit immigrant family, Neal's values were shaped early by the examples set by his parents and grandparents. After building an impressive career in finance, a series of personal experiences as a caregiver—first supporting his grandfather through end-of-life care, then facing his wife's severe illness—transformed his outlook and priorities. He became intimately aware of both the emotional toll and practical challenges caregivers face and the systemic flaws that make caregiving in America so difficult.These experiences motivated Neal to leave his high-powered finance career to focus on creating social impact. He founded Carry Ya, a not-for-profit project that connects families in need with qualified, motivated student caregivers at affordable rates, disrupting the expensive, often impersonal agency model. Neal is also the author of the book "Insured to Death," which exposes the failures of the American health insurance system, and he launched Counterforce Health, an AI-powered platform that empowers patients and caregivers to fight insurance denials. Neal's innovative, empathetic responses to systemic challenges underline his commitment to honoring caregivers as the backbone of the healthcare system and ensuring that their support, as well as that of care recipients, is financially and emotionally sustainable.About Neal:America's Chief Elder Officer. CEO of CareYaya Health Technologies and Chairman of Counterforce Health. Working hard to improve healthcare. Author of #1 Bestseller in Health Policy, "Insured to Death: How Health Insurance Screws Over Americans - And How We Take It Back". After a successful career as a $250 million hedge fund manager, deeply personal caregiving experiences inspired a pivot to social entrepreneurship. Now, determined to transform care delivery through technology.Building a rapidly-growing tech startup to expand access to affordable care. Pioneering cutting-edge AI applications and neurotechology to fundamentally elevate quality of life for those needing care. Motivated by creativity and humanitarian progress.Leveraging experiences guiding multi-billion dollar investments to make an impact on improving care for our most vulnerable populations. Leading with both heart and analytical rigor.Building unrivaled technical capabilities and strategic partnerships to establish CareYaya as America's leading launchpad for care innovation. Together, let's build a better future for care! Thank you to sponsor: CareScoutSupport the showConfessions of a Reluctant Caregiver Sisterhood of Care, LLC Website: www.confessionsofareluctantcaregiver.com Like us on Facebook! Tweet with us on Twitter! Follow us on Instagram! Watch us on Youtube! Pin us on Pinterest! Link us on LinkedIn!Tune in on Whole Care Network
Epicenter - Learn about Blockchain, Ethereum, Bitcoin and Distributed Technologies
In this episode, Sebastien Couture is joined by Benjamin, the founder of CAP, a stablecoin protocol designed to provide insured yield. The protocol features two main products: CUSD, a digital dollar, and stCUSD, its staked, yield-bearing version. Yield is generated through an "allocation engine" where third-party operators borrow from the protocol's reserve to execute yield strategies. To ensure user deposits, these operators must be vouched for by restakers on protocols like Symbiotic. If an operator defaults, the restakers who vouched for them are slashed, protecting the stablecoin holders' funds. This model shifts risk from the end-user to the restakers, who have a bilateral relationship with the operators they underwrite, often backed by legal agreements.Topics covered in this episode:Benjamin's background and perspective on ChinaJourney into crypto and stablecoinsHot Take: Stablecoins are not as safe as you thinkThe evolution of stablecoin modelsHas DeFi forgotten about decentralization?CAP's design: CUSD and stCUSDHow CAP generates yield with operators and restakersThe role of restakers and legal agreementsIntegrating with Symbiotic and views on EigenLayerThe best use cases for shared securityNavigating the Genius Act and global regulationsRebuilding trust in the DeFi ecosystemWhy the stablecoin space is not too crowdedEpisode links:Benjamin on XCap MoneySponsors:Gnosis: Gnosis builds decentralized infrastructure for the Ethereum ecosystem, since 2015. This year marks the launch of Gnosis Pay— the world's first Decentralized Payment Network. Get started today at - gnosis.ioThis episode is hosted by Sebastien Couture. Show notes and listening options: epicenter.tv/618
In this powerful episode of Love Conquers Alz, Susie Singer Carter and Don Priess sit down with Neal K. Shah, visionary founder and CEO of CareYaya, a groundbreaking platform that connects families with compassionate, college-educated student caregivers. Neal shares how his personal caregiving journey inspired him to reimagine elder care, creating affordable, dignified, and deeply human support that benefits both older adults and the next generation of healthcare professionals.Together, they explore the urgent need to bridge generational divides, destigmatize dementia, and cultivate empathy in future doctors and nurses by immersing them in real-life caregiving experiences. Neal also opens up about his new book, "Insured to Death", which takes aim at the rising crisis of AI-driven healthcare claim denials and the devastating toll they take on patients and families.From stories of students forming life-changing bonds with people living with dementia, to hard truths about our broken long-term care and insurance systems, this conversation is both eye-opening and hopeful. It's a reminder that caregiving—when rooted in love, purpose, and community—has the power to transform lives.Counterforce HealthCareyaya.orgSupport the showNo Country For Old People; a Nursing Home Exposé is STREAMING NOW on Amazon Prime (https://www.amazon.com/gp/video/detail/B0F7D1RR5X/ref=atv_dp_share_cu_r) Please watch. Review. Share. Be a ROAR-ior!! JOIN THE R.O.A.R. MOVEMENT for quality long term care! Visit the No Country For Old People Website for more information.YOU CAN ALSO SUPPORT THE ABSOLUTELY CRUCIAL PROMOTION OF OUR DOCUMENTARY "NO COUNTRY FOR OLD PEOPLE" BY MAKING A TAX DEDUCTIBLE DONATION THROUGH THE NATIONAL CONSUMER VOICE HERE Follow us on Twitter, FB, IG, & TiK Tok
On this episode of Managed Care Cast, The American Journal of Managed Care® (AJMC®) speaks with Tory M. Wolff, MBA, an author of a study published in the September 2025 issue and managing partner of Recon Strategy, a management consulting firm specializing in health care strategy. His study, "Impact of More Primary Care Visits on Commercial Health Care Costs," found that more frequent routine primary care visits among certain higher-risk commercially insured adults are associated with lower net population-level health care costs. In this conversation, Wolff explores the inspiration behind his research, expands on his findings, and discusses the next steps to better understand the long-term value of routine primary care in commercial populations.
A few months ago, today's insured decided to jump into the latest trend for a lot of suburban dwellers, and he got some chickens! He built a chicken coop and a caged in area for the chickens to be safe from predators. The coop itself looks like a very large shed with a fenced-in area extending from the coop. The insured calls up their agent to ask if there's coverage for the coop under their HO 00 03 03 22 policy covering their home and an attached garage. Notable Timestamps [00:00] - A homeowner built a large chicken coop and asked their insurer whether it was covered under their 2022 homeowners policy. [02:00] - The hosts dive into trivia, noting that chickens are genetically the closest living relatives to the T-Rex. [05:00] - Coverage depends on construction: a coop attached to the house may fall under Coverage A, but detached coops lean toward Coverage B or C. [07:30] - One key test is portability: if the coop can move with the owner, it likely counts as personal property under Coverage C. [10:00] - Courts consider a variety of factors, e.g. how the coop is affixed, its adaptation for use, and the owner's intent to keep or move it. [12:30] - Some coops are deliberately not anchored to protect against flooding or predators, adding complexity to coverage classification. [14:25] - Similar issues arise with swing sets, pools, and other backyard structures—each must be evaluated individually. [15:15] - Selling eggs could cross the line into business use, potentially excluding coverage under standard homeowner policies. [18:00] - Coverage type affects settlement: Coverage B buildings may qualify for replacement cost, while Coverage C property is typically ACV. [20:00] - Beth provides a recap of the points above. Your PLRB Resources Coverage Question: Other Structures Used for Business – Raising Chickens https://www.plrb.org/documents/other-structures-used-for-business-raising-chickens/ Other Structures: Can Some Items Be Treated As Either Coverage A Or Coverage B Property? https://www.plrb.org/documents/other-structures-can-some-items-be-treated-as-either-coverage-a-or-coverage-b-property-pcq-2022-01-17-jem-a/?search=other%20structures Employees of member companies also have access to a searchable legal database, hundreds of hours of video trainings, building code materials, weather data, and even the ability to have your coverage questions answered by our team of attorneys (https://www.plrb.org/ask-plrb/) at no additional charge to you or your company. Subscribe to this Podcast Your Podcast App - Please subscribe and rate us on your favorite podcast app YouTube - Please like and subscribe at @plrb LinkedIN - Please follow at “Property and Liability Resource Bureau” Send us your Scenario! Please reach out to us at 630-509-8704 with your scenario! This could be your “adjuster story” sharing a situation from your claims experience, or a burning question you would like the team to answer. In any case, please omit any personal information as we will anonymize your story before we share. Just reach out to scenario@plrb.org. Legal Information The views and opinions expressed in this resource are those of the individual speaker and not necessarily those of the Property & Liability Resource Bureau (PLRB), its membership, or any organization with which the presenter is employed or affiliated. The information, ideas, and opinions are presented as information only and not as legal advice or offers of representation. Individual policy language and state laws vary, and listeners should rely on guidance from their companies and counsel as appropriate. Music: “Piece of Future” by Keyframe_Audio. Pixabay. Pixabay License. Font: Metropolis by Chris Simpson. SIL OFL 1.1. Icons: FontAwesome (SIL OFL 1.1) and Noun Project (royalty-free licenses purchased via subscription). Sound Effects: Pixabay (Pixabay License) and Freesound.org (CC0).
Barbra Merwin, president of Travel Insured International, has more than 30 years of experience in insurance, beginning her career in the claims adjustment department at State Farm Insurance. In this episode of Humans of Travel, Merwin shares her personal journey — from her upbringing in Minnesota to leading a full company transformation and rebrand at TII. Listeners will hear Merwin’s views on how travel insurance gives travelers much-needed peace of mind — and her vision for how travel protection can elevate the advisor–client relationship. She also reflects on the lessons learned early in her career, and her views on mentorship. Plus, advisors will get the inside scoop on what exactly should be included in a travel insurance policy, and learn more about TI’s travel advisor certification program. This episode is sponsored by Travel Insured International. RESOURCES MENTIONED IN THIS EPISODE Travel Insured International Become a Partner With Travel Insured International ABOUT YOUR HOST Emma Weissmann is the Executive Editor of TravelAge West, a print magazine and website for travel advisors based in the Western U.S. She is also the co-host of Trade Secrets, a podcast created with sister publication Travel Weekly, and the Editor-in-Chief of print publication AGENTatHOME.TravelAge West also produces events including Future Leaders in Travel, Global Travel Marketplace West, the WAVE Awards gala ad the Napa Valley Leadership Forum. ABOUT THE SHOW TravelAge West’s award-winning podcast, “Humans of Travel,” features conversations with exceptional people who have compelling stories to tell. Listeners will hear from the travel industry’s notable authorities, high-profile executives, travel advisors and rising stars as they share the highs and lows that make them human.See omnystudio.com/listener for privacy information.
Discover the urgent realities and innovative solutions at the intersection of healthcare, insurance, and technology in this compelling episode of Healthcare Insights at Northwest North Carolina. Host Andrew Brewer welcomes Neil K. Shah—CEO, author, and founder of Counterforce Health—to unpack the growing crisis of health insurance claim denials and their profound impact on patients, providers, and the entire healthcare system. Drawing from personal caregiving experiences and professional expertise, Neil K. Shah reveals how AI-powered tools are empowering clinicians, hospitals, and patients to successfully appeal denied claims, reduce administrative burnout, and restore the integrity of care. The conversation highlights the financial and moral challenges faced by healthcare teams, the threat to independent and rural practices, and the urgent need for advocacy and systemic reform. This episode offers actionable insights and hope for a more equitable future in healthcare. Tune in to learn how technology and grassroots collaboration are shifting the balance of power back to those who need it most. Find out more about Neal and Counterforce Health at https://www.counterforcehealth.org/
Contractor Success Map with Randal DeHart | Contractor Bookkeeping And Accounting Services
This Podcast Is Episode 642, And It's About How To Know If It's Time To Raise Your Rates Without Losing Clients A Practical Guide for Contractors Who Want to Stay Profitable—Without Scaring Off Business If you're like most small construction business owners, you've probably had this thought: "I'm working non-stop, but I'm still barely keeping up—should I raise my prices?" And then right after that, the fear kicks in: "What if I lose clients? What if no one can afford me anymore?" As construction bookkeeping specialists, we hear this frequently. Contractors are nervous to raise their rates because they worry it'll cost them jobs or damage their reputation. But here's the truth: Raising your rates isn't about greed—it's about survival. In this post, we'll guide you through understanding when it's time to increase your rates, how to do it without losing your best clients, and how your books can provide the data and confidence to price with clarity. Why Contractors Hesitate to Raise Rates Let's start with the everyday fears: "My clients won't pay more." "I'll lose out to cheaper competition." "What if I price myself out of the market?" These fears are common, but often based on assumptions rather than data. Low rates can hurt your business more than help it. They lead to: Burnout from overwork Poor-quality clients who expect a lot and pay late Inability to reinvest in tools, help, or marketing Projects that cost more than they bring in So let's flip the script. Instead of fearing a rate increase, let's explore how to raise with purpose—and use facts, not fear, to guide your pricing. 1. Start with Job Costing Before raising rates, you need to know one thing clearly: Are you actually making money on your jobs? Job costing is the process of tracking: Labor hours (including your own!) Material and supply costs Subcontractor fees Equipment and tool usage Permits, dump runs, gas, insurance A share of your overhead (office, truck, phone, software) Once you tally this up, compare it to what you charged. If you're seeing slim margins—or worse, negative ones—you're undercharging. Bookkeeper's Tip: Start by reviewing your last 5–10 jobs. Break them down into: Estimated vs. actual cost Hours quoted vs. hours worked Gross profit (before overhead) Net profit (after overhead) Even a simple spreadsheet can help you see which jobs are winners—and which ones need a pricing tune-up. 2. Watch for These Signs - It's Time to Raise Rates Still unsure? Here are seven signs it's time to raise your prices: 1. You're booked out for weeks (or months) This means demand is high, and your pricing may be too low. If people are lining up, a modest increase won't deter them. 2. You're working too hard for too little If you're exhausted, working weekends, and still not taking home enough, your rate is too low. Period. 3. You haven't raised your prices in over a year Material costs, fuel, insurance, and labor have all increased. If your rates haven't changed, you're likely absorbing the difference. 4. Your quality has improved Are you more skilled than when you started? Do you offer better results, smoother communication, or cleaner job sites? Then you should be charging for it. 5. You're attracting low-quality clients If you constantly deal with haggling, late payments, or poor communication, your pricing is attracting bargain hunters rather than quality clients. 6. Your tools, overhead, and team cost more Running a legit business costs money. If you're licensed, insured, and invest in quality, your rates should reflect that. 7. You're turning away work If you're saying no to jobs because you're too busy, that's a strong sign it's time to raise your prices and focus on higher-value projects. 3. How to Raise Rates Without Losing Good Clients You don't need to double your rates overnight or announce a price hike in bold letters. Here's how to do it strategically and professionally: A. Start with New Clients This is the easiest path. Quote your new price to new inquiries in the future. They won't know the old rate, so there's no resistance. B. Add Value, Not Just Cost When raising rates, remind clients of what they're getting: Better project management Faster turnaround Clearer communication Higher quality materials Insured and dependable work Frame your pricing as an investment, not just a fee. C. Offer Tiers or Packages For price-sensitive clients, offer a few levels of service: Basic (bare-bones scope) Standard (your usual full-service) Premium (extras like design, faster turnaround, etc.) This helps clients self-select based on budget without forcing you to underprice your work. D. Phase In Rate Increases If you work with repeat clients, give them a heads-up: "Due to rising material and labor costs, I'll be increasing my hourly/project rates starting [date]. I wanted to let you know in advance so we can plan accordingly." Most reasonable clients will understand, especially if you've consistently delivered value. 4. Use Pricing Psychology to Your Advantage Pricing is part math, part mindset. Here are a few tactics to make your price increases feel smoother: Avoid round numbers Instead of $1,000, say $1,175 or $3,950. It feels more calculated, not random. Anchor with options Show your higher price next to a more expensive (or less valuable) one. This frames your offer as the "just right" choice. Include a price breakdown. Show labor, materials, subs, overhead—so clients understand what goes into your rate. Be confident Clients can sense uncertainty. If you hesitate or over-explain, it creates doubt. Quote clearly and stand behind your values. 5. Track What Happens Next After you raise rates, keep an eye on: Win/loss rate (are fewer clients saying yes?) Job profitability (are you keeping more after costs?) Client satisfaction (any change in feedback or reviews?) Hours worked vs. income (are you earning more with less hustle?) Often, you'll find you're getting fewer clients, but better ones. And that's the goal: less chaos, more profit, and more control over your schedule. Final Thoughts You Deserve to Be Paid for What You're Worth You started your business to build freedom, not to be overworked and underpaid. Raising your rates isn't risky when data, systems, and experience back it. It's a sign of growth and professionalism. The right clients will respect it, and you'll finally start seeing the kind of income and balance your hard work deserves. Need Help Understanding Your Numbers Before You Raise Rates? As a construction bookkeeping specialist, we help contractors: Break down job costs Analyze profit margins Clean up financials Set pricing that actually works As we always say, Contractors like you deserve to be wealthy because you bring value to other people's lives. You don't need more jobs. You need the right jobs at the correct rate. Let's get you there. About The Author: Norhalma Verzosa is a Certified Construction Marketing Professional and serves as the Web Administrator of Fast Easy Accounting, located in Lynnwood, WA. She holds a Bachelor's Degree in Psychology and is a Certified Internet Web Professional, with certifications in Site Development Associate, Google AdWords Search Advertising, and HubSpot Academy. She manages the entire web presence of Fast Easy Accounting using a variety of SaaS tools, including HubSpot, Teachable, Shopify, and WordPress.
Lowenstein Sandler's Insurance Recovery Podcast: Don’t Take No For An Answer
In this episode of Don't Take No For an Answer, Eric Jesse and Alexander B. Corson review an update in the 3M self-insured retention decision after the Delaware Supreme Court closely ruled in favor of the insurer. The majority ruling enforced unusual language in a legacy CGL policy despite the dissent's view that the ruling elevated form over substance. Jesse and Corson advise policyholders to pay close attention to policy language and to be on the lookout for traps, even those that seem like a "pointless formality." Listen to the previous episode on this matter here. Speakers: Eric Jesse, Partner, Insurance RecoveryAlexander B. Corson, Associate, Insurance Recovery
In this episode of The Patient From Hell, host Samira Daswani speaks with Neal K. Shah — TEDx speaker, former hedge fund manager, and now social entrepreneur reshaping the caregiving economy.After building a multi-billion-dollar hedge fund in his 20s, Neal's life changed dramatically when cancer struck his wife. As her primary caregiver, he experienced firsthand the crushing financial toxicity, social isolation, and emotional toll caregivers face.Today, Neal runs social enterprises tackling the caregiving crisis, has authored Insured to Death, and is exposing how AI is being weaponized by insurance companies to deny life-saving care.This conversation covers:The untold burden on family caregiversWhy health insurance often fails in catastrophic illnessHow financial toxicity devastates householdsThe rise of AI-driven claim denialsNeal's mission to “arm the resistance” with AI tools for patientsIf you've ever wondered why healthcare feels broken — or how we can fix it — this episode will leave you informed and inspired.
Many seniors today face significant financial strain—some even resort to borrowing to cover their basic living expenses.For retirees on a fixed income, a reverse mortgage can be a practical solution to access the equity in their home and bring much-needed stability. Harlan Accola joins us today with a message of hope for those looking for margin in their retirement years.Harlan Accola is the National Reverse Mortgage Director at Movement Mortgage, an underwriter of Faith and Finance. He is also the author of Home Equity and Reverse Mortgages: The Cinderella of the Baby Boomer Retirement.The Real Issue: Seniors Struggling with Credit Card DebtNearly 70% of seniors that Movement speaks with are carrying credit card debt. These aren't impulsive spenders buying luxury items. They're retired, living on fixed incomes, and they're relying on credit just to pay for basics like groceries and prescriptions. They're often asset-rich but cash-poor—sitting on significant home equity but drowning in interest rates of 25% to 35%.Many people suffer silently, too embarrassed to discuss their financial challenges. They don't realize that the equity in their home could be used to ease their burden without losing the home they love.One of the biggest hurdles is the spread of misinformation. People believe they'll lose their house, or that a reverse mortgage is inherently bad.In truth, the Home Equity Conversion Mortgage (HECM)—the most common form of reverse mortgage—is federally insured and designed to protect both the homeowner and their heirs. Properly structured, it can be a safe and responsible tool.Who Should Consider a Reverse Mortgage?Anyone over 62 with at least 50–60% equity in their home should take a closer look. A typical scenario might be someone still making monthly mortgage payments, even with a small remaining balance. Those payments—$800, $1,500 or more—can strain fixed retirement budgets.One common misconception is that you lose control of your home. In fact, you and your spouse can stay in your home for life, even if one of you passes away. You can choose how to receive the funds—from monthly income to a lump sum to the most popular option: a line of credit.Whether it's a car repair or a medical bill, reverse mortgage lines of credit provide flexibility. And it's all about wise stewardship.At the heart of this decision is a stewardship principle. As Proverbs 24:3 reminds us, “By wisdom a house is built, and through understanding it is established.” It doesn't make sense to live in a paid-off home but struggle to pay for groceries while racking up 30% interest on credit cards. That's not good stewardship.Reverse mortgages aren't for everyone—but many avoid them simply due to fear or misunderstanding. For some, it could be a life-giving solution.If you're entering—or well into—retirement and want to explore whether a reverse mortgage might be a fit for your situation, visit Movement.com/Faith. On Today's Program, Rob Answers Listener Questions:I'm 71 and still working, but I'm not sure how much longer I'll be able to keep it up. Would a reverse mortgage help me eliminate my monthly mortgage payment, allowing me to manage better if I need to stop working?I have recently retired and hold a 401(k) account with Fidelity. Someone mentioned a company called Big Money Retirement Solution, which offers a 9% annual return on an annuity. Should I consider moving half of my portfolio there?I heard there's a way to get a free credit report that the government requires. How do I access that?Resources Mentioned:Faithful Steward: FaithFi's New Quarterly Magazine (Become a FaithFi Partner)Movement MortgageAnnualCreditReport.comWisdom Over Wealth: 12 Lessons from Ecclesiastes on MoneyLook At The Sparrows: A 21-Day Devotional on Financial Fear and AnxietyRich Toward God: A Study on the Parable of the Rich FoolFind a Certified Kingdom Advisor (CKA) or Certified Christian Financial Counselor (CertCFC)FaithFi App Remember, you can call in to ask your questions most days at (800) 525-7000. Faith & Finance is also available on the Moody Radio Network and American Family Radio. Visit our website at FaithFi.com where you can join the FaithFi Community and give as we expand our outreach.
Neal Shah didn't start out in life to change the healthcare system but after seeing the result of denied insurance claims in his own life, he set out to create a solution. Getting the coverage our premiums pay for shouldn't be an additional stressor added to the medical situation we are dealing with. Neal explains:How Consumers Can Use AI to Fight Claims - Insurance companies are weaponizing AI while doctors and patients are still using pen and paper. Neal outlines how patients can use tools available right now to appeal insurance claims and fight back.Your Healthcare Rights Playbook - Neal breaks down what patients and their advocates need to attain in simple layman's terms in order to best challenge insurance appeals.A Three-Layer Solution for American Healthcare - Neal shares his comprehensive approach for how healthcare can be improved in this country via universal catastrophic coverage, expanded HSAs and subscription-based healthcare models that can eliminate the insurance bureaucracy.Neal Shah is the CEO of CareYaya Health Technologies, a social enterprise and research lab advancing health equity for aging populations that was named one of America's Top 50 Startups in 2024. He also serves as Chairman of Counterforce Health, an AI platform for navigating insurance claim denials. His new book Insured to Death:How Health Insurance Screws Over Americans - And How We Take It Back is a searing exposé-meets-survival-guide, ripping the lid off America's denial-driven insurance machine that's bankrupting families and costing lives. Visit ConfidenceThroughHealth.com to find discounts to some of our favorite products.Follow me via All In Health and Wellness on Facebook or Instagram.Find my books on Amazon: No More Sugar Coating: Finding Your Happiness in a Crowded World and Confidence Through Health: Live the Healthy Lifestyle God DesignedProduction credit: Social Media Cowboys
More than half of insured homeowners are unaware they receive only a limited level of compensation for damage to their land from natural hazards. Natural Hazards Commission Toka Tu Ake chief strategy officer Michala Beacham spoke to Corin Dann.
Black Expat Journey with Charlotte Van Horn Episode 63: Being Insured In Colombia - Part 2 Host: Charlotte Van Horn - Panama Expat | Radio Host | Entrepreneur | Speaker Guest: Angela Berrio - Insurance Agent - Medellin, Colombia Produced by: Elite Conversations Podcast Media www.eliteconversations.com
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A conversation with Neal ShahThe healthcare insurance system is on the cusp of collapsing.Enter former Wall Street hedge fund manager Neal Shah, who channelled personal experiences of managing care for family members into a mission for transforming our entire system.As CEO of social enterprise and health tech platform CareYaya and Chairman of Counterforce Health, Neal is dedicated to spearheading a revolution: bringing direct relationships to the forefront and bypassing huge corporations.With costs rising, health statistics worsening, a workforce tiring, a population ageing - the time is now to act for change.—We spoke about concepts from his new book Insured to Death, the systemic failures of health insurance in America, how patients can use AI and advocacy to challenge claim denials, and what it will take to build a more humane, transparent system that serves us all.Follow me on Instagram and Facebook @ericfethkemd and checkout my website at www.EricFethkeMD.com. My brand new book, The Privilege of Caring, is out now on Amazon! https://www.amazon.com/dp/B0CP6H6QN4
Discover all of the podcasts in our network, search for specific episodes, get the Optimal Living Daily workbook, and learn more at: OLDPodcast.com. Episode 3224: Sam challenges the assumption that financial independence eliminates the need for life insurance, offering seven compelling reasons to maintain or purchase a policy, even when you can self-insure. From estate liquidity to tax efficiency and protecting future dependents, he outlines how the peace of mind life insurance brings often outweighs the cost, especially for those with families or complex asset portfolios. Read along with the original article(s) here: https://www.financialsamurai.com/get-life-insurance-financially-independent-can-self-insure/ Quotes to ponder: "You may leave behind stocks, bonds, real estate, fine art, and collectibles, but they require an extra step to become liquid." "If you think you've got a greater chance of dying before the term limit is up, then life insurance becomes a better deal." "Providing peace of mind to your loved ones is a major reason why people buy life insurance." Learn more about your ad choices. Visit megaphone.fm/adchoices
Discover all of the podcasts in our network, search for specific episodes, get the Optimal Living Daily workbook, and learn more at: OLDPodcast.com. Episode 3224: Sam challenges the assumption that financial independence eliminates the need for life insurance, offering seven compelling reasons to maintain or purchase a policy, even when you can self-insure. From estate liquidity to tax efficiency and protecting future dependents, he outlines how the peace of mind life insurance brings often outweighs the cost, especially for those with families or complex asset portfolios. Read along with the original article(s) here: https://www.financialsamurai.com/get-life-insurance-financially-independent-can-self-insure/ Quotes to ponder: "You may leave behind stocks, bonds, real estate, fine art, and collectibles, but they require an extra step to become liquid." "If you think you've got a greater chance of dying before the term limit is up, then life insurance becomes a better deal." "Providing peace of mind to your loved ones is a major reason why people buy life insurance." Learn more about your ad choices. Visit megaphone.fm/adchoices
Black Expat Journey with Charlotte Van Horn Episode 62: Being Insured In Colombia - Part 1 Host: Charlotte Van Horn - Panama Expat | Radio Host | Entrepreneur | Speaker Guest: Angela Berrio - Insurance Agent - Medellin, Colombia Produced by: Elite Conversations Podcast Media www.eliteconversations.com
This is happening in Aurora, Colorado. https://www.lehtoslaw.com
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