A few weeks ago, a prospective client approached our company seeking Intellectual Property Coverage. He did not fully understand the coverage but was adamant that a policy be issued as quickly as possible. Of course this raised some red flags. Upon further discussions, it was noted that his software company was being sued for copyright infringement from a US based company. Since there was a pending litigation in place, we were unable to assist in providing coverage and suggested he contact law firms that specialize in Intellectual property disputes. This unfortunate incident could have been avoided if his current insurance broker and the client took the necessary time to fully understand the business model and possible exposures. The policy issued to this client was a standard CGL policy covering premises liability and specifically excluded trademark, patent and copyright infringement. In today’s fast paced & uncertain economic environment, intellectual property suits involving infringement of trademark, copyright and patents are being filed and litigated at alarming rates with crippling costs to both parties involved.

So what exactly is Intellectual Property? It can be broken down as follows:

Industrial property – includes inventions (patents), trademarks & industrial designs
Copyright – includes literary & artistic works such as articles, novels, drawings, paintings, designs.

These exclusive legal rights allow the owners of intellectual property to prosper from the property they have created, thus allowing a financial incentive for the creation and investment in their intellectual property. However, many new start-ups in addition to small and medium sized companies do not fully understand their benefits or potential implications. These organizations may have very valuable rights but are unable to use them effectively while others are unintentionally violating intellectual property rights of others without being aware of costly legal ramifications.

Some important terminology was used above and should be explained further.

Patents – Cover new inventions including process, machine, manufacture or any new and useful improvement of an existing invention.

Trade-marks- Provide exclusive rights to word(s), symbols and designs to distinguish goods or services from others in similar marketplace.

Copyright – Only the copyright owner, often the creator of the work, can produce, reproduce, or grant permission to others to do so.

As technology moves ahead at lightning speed, it has made it increasingly easy to reproduce countless types of materials that are subject to copyright. Companies must be very careful not to infringe on the rights of others. Penalties for trademark, patent and copyright infringement have become very costly and will damage the reputation of these companies on a world wide scale. Up until the mid 1990′s, the primary assets of most companies was their building, equipment, stock etc. Not anymore. Although these items still are very valuable, intellectual property, computer data, customer information are just as valuable and could lead to financial hardship if they are not protected with proper security measures and specific insurance coverage’s.

When dealing with the various forms of IP, it is advisable to seek out a lawyer/law firm that specializes in copyright, patents, trademarks, or trade secrets. They should fully understand your business model and your technology as well as you do while being able to explain the legal issues in this complex field in clear, practical language that you can understand.

Another important way to protect IP is to obtain Intellectual Property Insurance. This coverage protects companies for copyright, trademark or patent infringement claims arising out of the company’s operation. An Intellectual Property policy will pay the costs to defend you if someone tries to claim the rights to the same business model, process, or application. As long as the company is not aware of any pending litigation, infringements or violations, one can apply for insurance to protect your trademark or patent. Very few standard insurance policies protect businesses from loss or damage to their intellectual property. Similar to seeking out a prudent lawyer, it is just as important to seek out a company that specializes in this type of insurance. Make sure the policy is not limited to your specific province or state but rather on a worldwide basis. With more and more insurance companies entering this market, it should be rather easy to obtain a policy that fits your exposure.

If you’re fortunate enough to have employer-provided health insurance, that narrows your options down to the plans that your employer offers. If you don’t have coverage through your job, perhaps an organization or association that you belong to will allow you to buy health insurance through them at a group rate.

Another option is to check your local Obamacare health insurance marketplace to see if you qualify for an upfront premium credit, which would get you reduced premium costs. Even if you don’t qualify for the credit right away, buying your health insurance through the marketplace means you may qualify for it when you file your tax return for the year.

If you can’t, or won’t, get health insurance from any of these sources, you’ll have to fall back on buying a private plan. It will give you the widest range of options, but likely will be far more expensive.

Decide which type of policy to buy

Health insurance policies come in a variety of basic types, although you may not have access to all of these options through your preferred source. Health Maintenance Organizations (HMOs) are a very common type of health insurance policy. With an HMO, you’re required to use healthcare providers within the policy’s network, and you have to get a referral from your primary care physician in order to see a specialist.

Preferred Provider Organizations (PPOs) are also quite common. A PPO health insurance policy has a network, but you’re not limited to in-network care — although using network providers is cheaper — and you don’t need referrals to see specialists.

Exclusive Provider Organizations (EPOs) are a hybrid between HMOs and PPOs. You’re required to stick to the plan’s network, but don’t need referrals for specialists. Finally, Point of Service (POS) plans are a less common option that are essentially the opposite of an EPO. You’re not limited to the POS plan’s network, but do need a referral to see a specialist.

Of the four common types of plans, an HMO or EPO tends to be cheaper than a PPO or POS with the same level of coverage. However, if network coverage is poor in your area, or you’re uncomfortable limiting yourself to network providers, it may be worth paying a little more to get a PPO or POS policy.

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High deductible versus low deductible

All things being equal, the higher a plan’s deductible is, the lower the monthly premiums will be. A high deductible means that you’ll have to pay a lot of healthcare expenses yourself before the insurance policy kicks in, but if you have few or no medical expenses in a given year, these plans can be a bargain. Very low medical expenses means that you probably won’t surpass the deductible, even of a low-deductible plan, so getting a high-deductible plan keeps your insurance costs as low as possible while still protecting you in case something catastrophic happens.

If you decide to go the high-deductible route, getting a Health Savings Account (HSA)-enabled plan, and funding it with at least the equivalent of a year’s deductible, is your best option. An HSA plan neatly covers the biggest weakness of a high-deductible health insurance policy – namely, that you’d have to shell out a great deal of money on a major medical expense before the insurance would take over. If you have a full-year’s deductible tucked away in your HSA, you can just use that money to finance your share of the expenses, while simultaneously enjoying the triple tax advantage that an HSA offers.

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Comparing coverage

There are two major factors that affect how well a particular plan will cover your medical expenses: the plan’s network and its coverage policies. Even if you choose a plan with out-of-network options, like a PPO, you’re still better off using in-network health providers as much as possible because doing so will reduce your costs. And the rules that a given health insurance policy uses to decide what’s covered and what’s not – and how much the co-pays will be – can make a huge difference in how helpful a particular policy really is for you.

For example, if there’s a rather pricey medication that you take every day, you’ll definitely want to get a health insurance policy that lists that medication on its formulary. If you travel a lot, stick to plans that offer good out-of-area treatment options. And if you already have a primary care physician, you’ll definitely want to pick a plan that includes your doctor in its network.

Finding the best deal

If you’re stuck between two or three different policies and can’t decide which one to choose, try this exercise. Multiply the monthly premium by 12 to get your annual cost for a plan, then add in the plan’s out-of-pocket maximum. The result is the most you would end up spending on health care if you had one or more major medical expenses during the year. Do this calculation for each plan you’re considering, then compare the results. The plan with the lowest total is likely the best deal for you.

With health and diseases becoming a major issue these days around the world, it has become A LOT more important to have more and more coders involved in the medical field for insurance. But what is medical coding? A medical coder, clinical coding officer, or diagnostic coder are professionals involved in the health care sector who analyze clinical documents and using proper classification systems, assign standard codes to them. They provide medical coding guidelines and suggestions to help regulate the ways doctors, nurses, and other medical staff provide care for their patients. There are three main types of medical coding:

1) ICD (International Classification of Diseases): These are codes used for describing the cause of illness, injury, or death.

2) CPT (Current Procedural Terminology): These deal with anesthesia, surgery, pathology, radiology, measurement procedures, and new technological changes in the medical field.

3) HCPCS Healthcare Common Procedure Coding System): These include outpatient hospital care, medical aid, and Medicare.

Let us look at some points as to why coding is necessary for the medical field.

DATA SYSTEMS
When the coding is paired with the data systems of the hospitals, a powerful tool is made. By doing so, a large number of data from various hospitals, clinics, and other sources are stored, accessed, and used from one large online data system. This implementation helps in the transfer of any patient’s data from any hospital to another for any medical purpose. This information helps doctors to be more connected and make wiser decisions, especially in cases involving the life and death situation of the patient.

PATIENT CARE

Coding is very much required for reimbursements, which include submitting medical claims with insurance companies and bills between insurers and patients. The transfer of information for bill related purposes requires medical records, patient’s medical needs, lab results, pathology records (if any), and any other related documents. Appropriate payment is possible only when the required diagnostic codes are put in place, which also means to verify in case the medical claim is denied by the insurance company.

REGULATIONS

Medical billing and coding fall under the rules and guidelines of many countries and states. Coders in this field are also responsible for protecting the privacy of the patients and their families. They are supposed to take safeguards to preserve the confidential details concerning the patient and his/her medical background in a safe place. Electronic medical records fall under the International Classification of Diseases (ICD-10) codes issued by the World Health Organization (WHO).

Medical coding analysts are in the front line in healthcare data analytics. They work in many types of healthcare setups and not necessarily in hospitals and clinics. Their valuable service is very functional for research and development in the medical field.