Crookedproviders, lien setup bleed comp system

If you need more proof the workers-comp system in California is a mess, look no furtherthan the report this week that indicted and convicted medical providers filedmore than $600 million in liens against workers-comp claims.

The lien system in the state continues to be fertile groundfor fraud. Designed as a safety net to ensure injured workers get treated, it’snow a slush fund for crooked medical providers and lawyers.

Fraud and abuse are rife in Southern California, wheremedical rings are targeting just-retired workers, says one insurance exec whowrote us this week. Runners hang out at Social Security offices and othervenues frequented by retirees. They entice the retirees to file claims byoffering free medical care and a windfall to supplement retirement income. Theretirees are brought to lawyers’ offices, signed up and then shuttled off to medical offices for“treatment.”

The number of worker “injuries” occurring on the last day ofthe job is rising, this exec says.

Legislation to help weed some of these abusive providers outof the system is cruising through the California legislature. The bill wouldban providers who’ve been kicked out of Medicare and Medicaid for over-billing.The bill sponsor says there’s evidence that crooked docs banned from governmenthealth plans have turned to workers comp to ply their trade.

The sponsor also says his legislation will target lawyers whosign up comp clients, but never actually interview them, then file claims forthem in distant cities and ultimately settle the cases for their fees — oftenwithout the workers’ knowledge.

The legislation is a good idea, but much more needs to bedone. Workers compensation in California is a huge, complex multi-facetedprogram. There are no easy answers on how insurers, employers, policymakers andothers can hit that sweet spot of minimizing fraud while making sure injuredworkers get the treatment they deserve. But finding a better way than the liensystem might be a good start.



There’san apocryphal story that has been bandied about for years, about an interviewwhere the interviewer asked a candidate: “Do something to surprise me”. Theinterviewee got out his lighter and set fire to the interviewer’s newspaper.It’s not an action we would advise emulating, but very definitely comes underthe heading of utterly incomprehensible interview questions.

Why do these questionsget asked?

"Whydo these questions get asked" is a tricky question to answer, but as itappears to have started in Silicon Valley during the tech boom its roots arelikely to be found in the free-thinking, mould-breaking philosophy that many ofthe tech pioneers applied to their businesses. Ultimately for some interviewerit’s about unearthing someone who offers more than just “can you do the job”.Wall Street soon followed suit and the practice has become more commonplace.The question for most of us is not why are they asked but how do I answer them?

Firstand foremost you should remember there isn’t a right answer, depending on thenature of the question, which these questions are about your thought processes,your coolness under pressure, your personality and your approach to problemsolving. What you don’t do is say, “I don’t know”, or “that’s a good question”and stare off into space. Let’s take the question: “How many cricket bats arethere in the world?” You could either pluck an answer out of thin air: “Threemillion?”, or go about figuring out how to work it out. “Well, if thepopulation of the sporting public in the UK is X, and a tenth of them playcricket, then that’s XX for the UK, plus another X for the cricketingpopulation in India…” etc. This is the sort of approach the employer would belooking for.

Five types of questionsyou might encounter

1.Lots of these questions fall along the lines of if you were a colour/ananimal/a garden gnome/a car/a food/a computer application (yes, really) whatone would you be and why? Try to think of the qualities of the object and howthey might relate to your skills or character.

2.What are all the different uses you can think of for a lemon? Apparently askedduring an interview for an airline pilot, this type of question is designed tofind out how much of a creative thinker you are.

3.Who would you invite to a dinner party/what superhero/movie character would yoube/who is your role model? In other words, what character traits do you mostadmire in other people and why? Think about what specific things they haveachieved and what it is about those achievements that you admire so much.

4.How many people will be on Facebook in New York on a Friday afternoon? Thereare a raft of questions that are much more technical in nature and much morealigned to the role you are seeking. This question was aimed at a marketingexecutive, and was probing how well they understand the use of social mediaaround the world.

5.Tell me a story. This is a firm favourite, and represents a golden opportunityfor you to tell a work-related anecdote that is also relevant to the role inquestion and also illustrates how you see other people and the world aroundyou.

Preparation,preparation, preparation

Thisis the key to a good interview. However, thesequestions are not something that you can easily prepare for. If your job is atechnical one, brush up on your technical knowledge. If it’s a creative role,keep a clear head and try to analyse how you would approach some of these typesof questions. Above all, expect the unexpected!



Important softwareefficiency criterion

Below is a list of the top 20 essential criterion forreliability, efficiency and ease of use for business software.If you are about to select new business software such as Accounting, BI, CRM,Payroll o

System reliability - good software should:

1. Be totallyreliable and consistently perform the required software functions

2. Provideinternal system controls to ensure accuracy, integrity and completeness eg datainput and accuracy checks, validation, authorization

3. Maintain fullrecords eg to:

· trace any transaction item

· provide a full audit trail

· provide a full record of all balances andtransactions

4. Support manualcontrol procedures eg control reports

5. Provide systemsecurity via multiple, configurable passwords / levels of security

6. Provide backupand restore facilities for programs and data

7. Support yourorganization, by running over your (chosen) network, database and hardwareplatform(s)

Operationalefficiency - good software should:

8. Provideconfigurable automation of system and businessworkflow processes

9. Require data tobe entered only once, with no re-keying

10. Have configurable parameter / table facilities

11. Provide easily configurable data import programs

12. Operate quickly and efficiently, with acceptablesystem performance

13. Enable real time and / or batch processing

14. Support the number of concurrent system users yourequire, at peak processing / enquiry times, with no degradation of systemperformance

15. Support your chosen operational set up eg whetherusing SaaS, running a Shared Service Centre, single or multiple sites

16. Have a vendor warranty as to the softwarespecification and performance

17. Run on industry standard hardware

18. Run with hardware independent operating system

Ease of use - goodsoftware should be:

19. Easy to learn, with:

· standard system commands

· colour coding

· on-screen help facilities

· clearly written user / system documentation

20. Easy to use, with:

· full access to all system functions, subject toindividual user security profile(s)

· straight forward system navigation

· short cut keys, pull down menus, scrollbackwards and forwards

· tailorable menus, screens, reports

· multi-tasking ie multiple applications / windowsopen at a time

· on-screen prompts and messages that are clearand helpful eg requesting input, identifying input validation errors orprocessing errors