My Conversation with an Anonymous Cigna Representative

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Cigna, do you even have a clue that dentists don’t like you?

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By Darrell K. Pruitt DDS

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Hi Dr. Pruitt,

I’m truly sorry for any negative experience you’ve encountered with us. Is there a claim, benefit, or authorization concern I can help with? Please email me at LetUsHelpU@cigna.com. I’d like an opportunity to assist.

At a time when interest rates are surging, and just when I request an increase, CIGNA REDUCED MY REIMBURSEMENTS! Never again will I do business with you, and will discourage other dentists from falling into your trap …. And that is why dentists don’t like #TeamCigna. 

What is your name, anyway. You know mine. Perhaps Linkedin’s transparency makes it a poor choice for marketing Cigna.

As if things could get no worse between Cigna and dentists, you censored my response!

NOTE: Cigna representatives prefer to remain anonymous for reasons of accountability.

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COMMENTS APPRECIATED

Thank You

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BUSINESS MEDICINE: https://www.amazon.com/Business-Medical-Practice-Transformational-Doctors/dp/0826105750/ref=sr_1_9?ie=UTF8&qid=1448163039&sr=8-9&keywords=david+marcinko

Health Insurance: https://www.amazon.com/Dictionary-Health-Insurance-Managed-Care/dp/0826149944/ref=sr_1_4?ie=UTF8&s=books&qid=1275315485&sr=1-4

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UNICORNS: Successful Private Companies?

The Healthcare, IT AND FINANCIAL Sectors

DEFINITION: A private, non-public, company valued at more than a billion dollars.

CITE: https://www.r2library.com/Resource/Title/0826102549

Now, just five months into 2021, there were 199 new companies that reached unicorn status (a private company with a $1+ billion valuation), eclipsing the 163 companies that reached unicorn status in all of 2020, according to Crunchbase data shared with Emerging Tech Brew. And it’s not just a pandemic rebound: That figure is higher than any full-year total over the last nine years. 

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Landscape lowdown 

After a 2020 full of stagnation and uncertainty, the VC scene is making up for lost time and then some. 

“Many of the concerns…that ground deal making to a halt have largely been alleviated in what many investors see as a new normal,” Joshua Chao, venture capital analyst at PitchBook told us. “We’re now seeing VCs invest in companies outside of their immediate networks and it’s just full steam ahead on deal making and fundraising.” 

Deena Shakir, partner at Lux Capital, said VCs are branching out of their traditional comfort zones to chase opportunities, leading to stiff competition and unprecedented valuations.

  • “Everyone [is] inching further upstream and downstream than their normal sweet spot,” Shakir said. “Hedge funds [are] now leading seed deals and seed funds [are] participating in growth deals.”

Why so exuberant? Blame the same Big Acceleration society underwent since Covid hit: the shift to digital. Tami Hutchinson, VP at Intel Capital, told us the pandemic-fueled digital transformation has now become “a critical must-have for all enterprises,” creating opportunities for startups to serve that need.

Health Care: Health care, financial services, and privacy and security are the most popular sectors for new $1+ billion companies, per Crunchbase. Shakir echoed that idea, saying Lux is most excited by deals at the intersections of “clinical data and AI, hardware and software, care delivery and clinical insights, [and] physical and digital security.”

More proof…

  • In Q1 2021, digital health startups amassed a record $6.7 billion in funding, on pace to eclipse the $14 billion raised in all of 2020.
  • On the fintech side, Webull, the Chinese-owned Robinhood rival, reached unicorn status in February after a $150 million funding round.
  • Israeli cybersecurity firm Wiz is an example of a fresh unicorn in the space—it was valued at $1.7 billion as of May 2021.

Looking ahead…VCs say it’s a safe bet to assume that more billion-dollar companies are on the horizon this year.

“For entrepreneurs, this is possibly one of the most founder-friendly periods we’ve seen in several years—all-time highs for valuations across the board coupled with all-time lows for deals,” Chao said.

ASSESSMENT: Your thoughts and comments are appreciated.

MORE: https://www.amazon.com/Business-Medical-Practice-Transformational-Doctors/dp/0826105750/ref=sr_1_9?ie=UTF8&qid=1448163039&sr=8-9&keywords=david+marcinko

RELATED: https://www.amazon.com/Comprehensive-Financial-Planning-Strategies-Advisors/dp/1482240289/ref=sr_1_1?ie=UTF8&qid=1418580820&sr=8-1&keywords=david+marcinko

THANK YOU

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Some Common Medical Practice Accounting Embezzlement Schemes

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Understanding How to Avoid Office Embezzlement – Old School

[By Dr. Gary L. Bode CPA, MSA]

Without proper internal accounting controls, a medical practice, clinic or any health entity would never reach peak efficiency or profitability. Internal controls designed and implemented by the practice physician-owner, help prevent bad things from happening.

Embezzlement protection is the classic example. However, internal controls also help ensure good things happen, at least most of the time. A procedural manual or text like: www.BusinessofMedicalPractice.com that teaches physicians how to deal effectively with, and avoid, common schemes is suggested.

Common Schemes

Here is a list of some embezzlement schemes to avoid; however it is imaginative and endless.

  • The physician-owner pocketing cash “off the books”. To the IRS, this is like embezzlement to intentionally defraud it out of tax money.
  • Employee’s pocketing cash from cash transactions.  This is why you see cashiers following protocol that seems to take forever when you’re in the grocery check out line. This is also why you see signs offering a reward if he/she is not offered a receipt. This is partly why security cameras are installed.
  • Bookkeepers writing checks to themselves.  This is easiest to do in flexible software programs like QuickBooks, Peachtree Accounting and financial software [www.Peachtree.com]. It is one of the hardest schemes to detect. The bookkeeper self-writes and cashes the check to their own name; and then the name on the check is changed in the software program to a vendor’s name.  So a real check exists which looks legitimate on checking statements unless a picture of it is available.
  • Employees ordering personal items on practice credit cards.
  • Bookkeepers receiving patient checks and illegally depositing them in an unauthorized, pseudo practice checking account, set up by themselves, in a bank different from yours. They then withdraw funds at will. If this scheme uses only a few patients, who are billed outside of the practice’s accounting software, this is hard to detect.  Executive-management must have a good knowledge of existing patients to catch the ones “missing” from practice records. Monitoring the bookkeeper’s lifestyle might raise suspicion, but this scheme is generally low profile, but protracted. Checking the accounting software “audit trail”, this shows the required original invoice deletions or credit memos in a less sophisticated version of this scheme.
  • Bookkeepers writing payroll checks to non-existent employees. This scheme works well in larger practices and medical clinics with high seasonal turnover of employees, and practices with multiple locations the physician-owner doesn’t visit often.
  • Bookkeepers writing inflated checks to existing employees, vendors or subcontractors. Physician-owners should beware if romantic relationships between the bookkeeper and other practice related parties.
  • Bookkeepers writing checks to false vendors. This is another low profile, protracted scheme that exploits the physician-owner’s indifference to accounts payable.

Assessment

Operating efficiency, safeguarding assets, quality patient care, compliance with existing laws, and accuracy of financial transactions are common goals of internal controls.

Conclusion

Your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too.

Then, subscribe to the ME-P. It is fast, free and secure.

Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com

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