When you need medical attention, sometimes it’s obvious where to turn: Lingering cough and sore throat? Make an appointment with your doctor. Think you might be having a heart attack? Get to the emergency room, stat.

Other times, though, the answer isn’t so clear. Maybe your doctor is booked for days, or you’re traveling far from home. Or maybe you get sick over the weekend when the office is closed. What should you do then? Knowing where to go is key to getting the best care—and might just save you time and money.

Right Care, Right Place

“If you’ve got a problem that strikes you as severe or maybe even life-threatening, like you’re vomiting blood or you wake up with the worst headache of your life—get to the hospital or call 911,” says Ellen Miller, MD, CareConnect medical director and professor of medicine at Hofstra Northwell School of Medicine. “But if you’ve got a problem that would normally make you go to your doctor, only your doctor isn’t available, an urgent care clinic is probably a better choice.”

Urgent care facilities specialize in the treatment of medical problems that are urgent (like the name says) but not severe enough to warrant a trip to the ER. These facilities don’t require appointments and are often open on weekends and in the evening. Their physicians can diagnose and treat patients for illness and minor injuries like cuts and sprains.

After-hours availability is just one of the benefits an urgent care facility has to offer, Miller says. “If you can avoid the emergency room, you’ll probably save yourself a lot of time,” she says. “The ER is going to prioritize the real emergencies. If your case is not that serious, you will spend a huge amount of time waiting and waiting.”

Saving the ER for real emergencies may save you money, too. The co-pay for an emergency room visit is usually higher than for a trip to urgent care or your own doctor, although the specifics vary between plans and tiers.

There’s one more thing worth remembering, Miller says, and that’s to make your primary care provider your go-to whenever possible. Schedule your check-ups, and when a routine problem crops up, see if you can get a same-day appointment. “The preferable scenario is almost always to go to your primary care physician,” Miller says. “That’s the person who knows you and your history, has your full medical record, and will be able to follow up with you after your treatment is over.”

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Jan. 19 (UPI) -- The largest money service business in the world agreed on Thursday to a half-billion dollar settlement over charges they failed to protect customers from fraud and permitted their agents to illegally launder money for customers.

Western Union will pay a $586 million fine after pleading guilty to charges of willfully failing to run an effective anti-money laundering program and aiding and abetting wire fraud with the U.S. Department of Justice, Federal Trade Commission and the U.S. Attorneys' Offices of the Middle and Eastern districts of Pennsylvania, Central District of California and Southern District of Florida.

"Western Union owes a responsibility to American consumers to guard against fraud, but instead the company looked the other way, and its system facilitated scammers and rip-offs," FTC Chairwoman Edith Ramirez said in a press release. "The agreements we are announcing today will ensure Western Union changes the way it conducts its business and provides more than a half billion dollars for refunds to consumers who were harmed by the company's unlawful behavior."

Based on a complaint filed Thursday in the U.S. District Court for the Middle District of Pennsylvania, Western Union violated U.S. laws when they processed thousands of transactions for Western Union agents and others as part of multiple national and international fraud schemes.

Among the allegations are criminals who contacted victims in the United States posing as family members, potential employers or people awarding some kind of prize asking for money to be wired to them. The company's agents were often complicit in the schemes, the FTC said, and sometimes took a cut of the money.

Previous cases have also established that Western Union failed to halt the transfer of hundreds of millions of dollars to human traffickers in China and drug traffickers in other parts of the world, as well as not adhering to laws requiring verification and investigation of daily transfer limits.

The settlement requires Western Union to block money transfers to any person who is the subject of a fraud report, provide clear warnings to consumers about fraud on their paper and electronic forms, refund fraudulently induced money transfers if the company did not follow proper anti-fraud protocol and to increase the availability for how consumers can file fraud complaints.

Western Union will also be monitored by an independent auditor for its adherence to the telemarketing sales rule, which bars companies from processing transfers known to be fraud, or those the company "should know is payment for a telemarketing transaction."

Western Union said in a press release it has increased compliance consistently during the last five years and has dedicated about 20 percent of its employees to compliance functions, noting the issues it settled Thursday occurred mostly between 2004 and 2012.

"We share the government's goal of protecting consumers and the integrity of our global money transfer network, and we worked hard to resolve these matters with the government," Western Union said in the release. "We are committed to enhancing our compliance programs to prevent illicit activity on our network and protect customers who transfer money to friends, family and businesses."

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Blockchain technology was developed to reinforce digital currency bitcoin, and is considered the most efficient technology against cyber fraud that allows financial transactions to be verified electronically over a network of computers.

While relatively nascent in India, the country too plans to embrace the Block Chain technology because of increased cybercrime in financial institutions. India’s southern state of Andhra Pradesh has been named as the first in Asia to introduce the Block Chain Technology Institute last month. This technology ensures security and scale by using a dispersed network.

Alex Tapscott in a Forbes report explains,blockchain is a vast, global distributed ledger or database running on millions of devices and open to anyone, where not just information but anything of value –like money and units of energy - can be moved and stored securely and privately peer to peer, and where trust is established, not by powerful intermediaries like banks, governments and technology companies, but rather through mass collaboration and clever code.

In India too, IT services and solutions companies are stepping in to leverage emerging blockchain technology applications for customers across market verticals.

Here are some sectors that plan to significantly invest on Blockchain.

BFSI

Banks are investing on implementing blockchain. This will resolve issues surrounding high rate on transactions and will allay the commotion expected from other financial institutions offering financial services at a lower cost than the banks themselves.

According to a blogpost on Infosys Finacle site by Rajashekara V. Maiya, blockchain technology has created a lot of buzz in the technology landscape compared to any other technology in the past. Perhaps, blockchain is considered to be the biggest disruption post ‘internet’.

A recent report by World Economic Forum (WEF) shows that 80 percent of banks are predicted to start blockchain projects by 2017 and $1.4 billion has been invested into the technology over the past three years. 90 central banks are looking at the technology. In the Indian context, even RBI is optimistic about advantages of using blockchain to prevent cheque frauds. There are many identity-related blockchain projects where organizations are focusing on know-your-customer (KYC) for banks.

Intellectual Property

With the rise of the internet, it is becoming increasingly difficult to protect digital intellectual property. Many new companies are coming up to address this issue with the aid of blockchain technology. blockchain is mostly linked with bitcoin and cryptocurrency, but its realm speeds beyond that. As blockchain is used as a virtual decentralised ledger to track bitcoin transactions, it can also track the actual rights of all kinds of digital content and Intellectual property from logos, to music, to books, to everything.

Energy

According to a Finextra report, the energy sector has seen significant changes over the past few decades across generation, distribution, storage, and consumption. The result is a complex, non-transparent and inefficient energy market leading to a lot of waste. Put simply, there isn’t a single, publicly available ledger of all energy transactions that take place in the industry. Though the data is there, it is very fragmented, hard to interpret, and largely underused as a result.

Blockchain infrastructure would provide an open, transparent and timely way to record transactions in the energy business, from generation through consumption.

Supply Chain

Global supply chain can add transparency and auditability with blockchain technology. Every time a product changes hands, the transaction could be documented. This will create a permanent record of a product, from manufacture to sale. blockchain technology reduces leaks in the chain and reduce time delays, added costs, human error and insurance costs.

Also Internet-of-Things (IoT) plays a major role in this vertical. Here IoT sensors can record sessions of objects on the blockchain, which will provide data diligence and optimize cost.

Government

Government has innumerable data all across, so we can imagine the settlement of all the dissidence if blockchain is used. It can also bring more transparency to the tax structure and citizens could gage how the money is being spent.

Also by moving the registries to blockchain, government can save money, increase transparency, and cull corruption.

According to a IndiaToday report, in possibly a first in Asia, Andhra Pradesh government has introduced blockchain technology to prevent incidents of cybercrime. It has introduced the technology in some departments to protect the database from being hacked.

However, Eric Piscini in a TechTarget report opined, “Mass adoption will not happen unless we have a regulatory framework and today these frameworks are inconsistent at best, and nonexistent in a few cases.”

“In addition, our legal environment needs to evolve to account for specific smart contracts, which are business logic running on blockchain and automatically executed, to be recognized in court,” said Eric.

Clearly, with rapid adoption of blockchain technology, the enterprises offering the same have a huge potential market to tap in 2017 and beyond.

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Closer look deters arsonists, discovers scams,benefits all policyholders

Kenny Allen was alikable fellow. He went to church, coached youth basketball in the Muncie, Ind.area, and was making his way through life with limitless potential ahead.

He also lived in asecret world: He was an insurance thief. Kenny was a driving force behind thelargest home arson ring in Indiana history. And one of the largest ever in theU.S. His gang helped torch at least 73 buildings while he sang hymns ofrighteousness in pews.

Insurers were easy todefraud, Allen says. Their adjusters were so intent on making customers happy —he contends — that they rarely asked tough questions. Insurers could’ve quicklyexposed the claims for burned homes as money grabs with a little more effort.

Kenny went straightafter nearly five years in federal prison. He admits he screwed up, and todaygives workshops for investigators to help make amends. He partners with MikeVergon, the former ATF agent who arrested him. They’re friends and supportersin life — a touching story of Kenny’s redemption.

Yet his saga speaks toa bigger dilemma for insurers. If they investigate too many claims too closely,they risk policyholders thinking they’re cold and money-grubbing.

If insurers let too many suspect claims slide through tooeasily, they risk being prey for hunters like Kenny was. This slippery slopecan grow fraud losses, help raise premiums and — yes — reinforce a belief amongmany consumers that insurers are cold and money-grubbing.

Life isn’t always fairwhen you’re an insurance company, no matter how many good deeds you perform. Corporations aretargets of consumer upset simply because they’re big and make money.

Checking closely intosuspicious claims can trigger a lot of emotions. Fair or not, people’s feelingsof aggrievement or entitlement can quickly damage an insurer’s reputation.Especially when viral social posts can reach millions of sympathetic consumersin just hours.

Over the longterm,it’s a risk worth taking, and a story worth telling.

Insurers should do afar better job of telling people why they fight fraud — and why allpolicyholders benefit.

Being justifiablyknown for protecting policyholders from thieves seems like a pretty good way tobuild a business brand. And doing right by consumers.

If Kenny Allen’sright, taking the easy way out could’ve cost insurers more than millions infalse arson claims. He’s the first to admit, it’s a miracle nobody died in hisfires.

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Keeping in MLR improveshealthcare for everyone

Health insurer anti-fraud expenses will be left from the Medical LossRatio in a rule released by the feds. This decision deals withMedicaid managed care, and frustrated state and federal fraud busters. Theimpact will spread throughout the world of healthcare.

First, a short history: The Affordable Care Act requires healthinsurers to spend 80 or 85 percent of costs on claims and health services. Thislimits how much insurers can spend to run the business.

Regulators were left to decide what insurer expenses will beincluded in the MLR. The Coalition and other fraud fighters diligently tried toshow federal and state regulators why anti-fraud expenses should be included.Effective fraud fighting is directly linked to the quality of healthcare thatconsumers receive in many cases.

What makes this decision a bit grating is that federally fundedhealth programs like Medicaid are required to have anti-fraud efforts. Yetthose expenses are excluded from the MLR, and thus, health plans have littleincentive to invest more in combating fraud.

This decision has impact well beyond state-federal Medicaid.

States usually look to the feds for guidance when writing theirown regulations. If the feds exclude fraud expenses from the MLR, then stateswill be reluctant as well.

We’ve urged insurance regulators to include the MLR. They’re oftensympathetic, yet gamely stick to excluding anti-fraud expenses.

Fraud fighting is essential to quality patient care; this isn’tmere overhead. Scams often harm patients with worthless and botched treatmentsthat also can max out their policy limits. Stopping money-draining schemes alsohelps reduce the cost of health services. This benefits everyone.

That’s the rub. Fraud fighters know that good anti-fraud effortsreduce healthcare costs and improve services. Yet regulators stubbornly stayreluctant to even consider including anti-fraud expenses in the MRL.

It’s time for fraud fighters to speak out, and tell regulators andpolicymakers that fraud-fighting expense should be included in the cost ofpaying healthcare claims.

About the author: Howard Goldblatt is director of governmentaffairs for the Coalition Against Insurance Fraud.

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Awardbestowed by New York Alliance Against Insurance Fraud

March 16, 2016, New York, NY — Cited for an aggressivecampaign to counter workers-compensation scams throughout the state, New YorkInspector General Catherine Leahy Scott was honored with the “Fraud Fighter ofthe Year” award by the New York Alliance Against Insurance Fraud.

The award was presented during NYAAIF’s recent annual meetingheld here.

NYAAIF Chair Jim Berrigan credited the IG’s leadership incompiling an impressive record of prosecuting wide-ranging workers-compensationcases. They included fraud by claimants, medical providers and businesses.

“The IG’s efforts put teeth behind our anti-fraud marketingcampaigns in providing valuable deterrence though public awareness and vigorousprosecution,” Berrigan said in presenting the award. He also commended Scottfor reaching out and working with insurers to identify fraud trends and developstrategies to counter them.

NYAAIF also previewed its 2016 consumer campaign. It willinclude TV & radio ads, billboards and a roaming “Fraud Squad” vanplastered with anti-fraud messages. The campaign theme is “Insurance FraudHurts . . . Everyone.” It launches in May.

Frank Orlando, head of the fraud unit of the state Departmentof Financial Services, briefed fraudfighters on no-fault fraud trends in the state. The MassachusettsInsurance Fraud Bureau profiled a huge automobile rate- evasion ring thatoperated in New York and Massachusetts.

NYAAIF also elected four members to three-year board terms:Jim Potts (New York Central Mutual), Frank Sztuk (Hanover Insurance), Ken Jones(Travelers) and James Egner (Farmers Insurance).

NYAAIF is an alliance of 104 insurance companies in New York.NYAAIF was created in 1999 to educate consumers about the cost of insurance fraud and help consumers avoid becomingvictims.

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