> Health Maintenance Organization (HMO) Managed-care insurers — known generally as HMOs — use a primary care physician as a gatekeeper to screen patients and see that appropriate treatment takes place at the lowest level possible. In order to see a specialist or receive specialized care, patients must see the gatekeeper physician first and be referred on.
> Dependent Property This refers to a kind of business-interruption endorsement on a commercial policy that protects you from financial losses caused by problems somewhere other than your business. “Dependent property” is defined as property not owned, operated or controlled by you but on which you are dependent for normal business operations.
> Earthquake coverage Quake coverage is available as additional coverage to standard commercial property and casualty policies. Earthquake coverage is available throughout Washington state, although it is relatively expensive for masonry structures and business operations with high-risk inventory or equipment.
When you have a Medigap policy, the insurance company must pay your doctor or provider directly when:
Your doctor or provider has signed an agreement with Medicare to accept assignment of all Medicare claims for all their Medicare patients, and
You tell your doctor's office to put on the Medicare claim form that you want Medigap insurance benefits paid to the doctor or supplier. Your doctor should put your Medigap policy number and the company name on the Medicare claim form. You will need to sign the claim form or have your doctor keep your signature on record. Make sure this information is correct.
When these conditions are met, the Medicare carrier will process the claim and send it to the Medigap insurance company. A Medicare carrier is a private company that has a contract with Medicare to pay Part B bills. The carrier will send you a Medicare Summary Notice. Your Medigap insurance company will pay your doctor or provider directly and then send you a notice. If you don't get this notice, you may ask your Medigap insurance company for it.
In most cases, Medicare claims are sent directly to the insurance company, even if the doctor doesn't accept assignment on all claims.
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Did You Know?
There are several areas of risk that you should consider if you operate a business in your home.
These include: Business-related personal property coverage (computers, furniture, etc.) Inventory Off-premises coverage for business-related personal property Business property of others accounts receivable (up to a specified limit) Liability coverage may include personal injury, products and completed operations, incidental contractual liability, and general commercial liability. Electronic data processing coverage Valuable papers Business interruption and extra expense
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