Tuesday, June 30, 2015

Amazon to Offer Loans to 8 Countries

By Nandita Bose


CHICAGO (Reuters) – Amazon.com Inc will launch its business loan program for small sellers later this year in eight more countries including China, where credit is becoming a key factor in competing for new vendors and grabbing market share.


Until now, the e-retailer has offered the service only in the United States and Japan. Amazon Lending, founded in 2012, now plans to offer short-term working capital loans in other countries where it operates a third-party, seller-run marketplace business, the head of Amazon Marketplace, Peter Faricy, told Reuters.


The countries are Canada, China, France, Germany, India, Italy,Spain and the United Kingdom.


The service is on an invite-only basis and is not open to all sellers on Amazon’s platform.


Other large retailers including eBay Inc’s PayPal and Alibaba Group Holdings, which run third-party marketplaces, are also turning to credit to boost their vendor base.


Some lending industry officials who help lenders assess credit risk say these retailers are taking on risky loans because they don’t know the shape of the credit market in which the sellers are operating.


Small businesses have high failure rates, especially in China and India, added William Black, a former U.S. banking regulator and professor of Economics and Law at the University of Missouri.


Amazon said it can safely offer loans based on internal data and because it takes loan payments out of the sales proceeds it pays sellers.


PayPal spokesman Josh Criscoe said eBay merchants who use PayPal are eligible for the working capital loans and credit is offered to only those customers that have a strong PayPal sales history. PayPal has provided more than $500 million in capital since September 2013, with an average loan disbursement of $2 million per day.


A spokeswoman for Alibaba’s financial services arm Ant Financial, which offers these loans, said credit is offered to Taobao, Tmall merchants and other small business owners who meet certain conditions. The company also offers such loans to customers in some countries like the United States and Britain.


Since 2011, Ant Financial’s Ant Micro Loan program has issued 400 billion yuan ($64.42 billion) worth of loans, and the non-performing loan ratio is 1.5 percent, the spokeswoman added.


Amazon offers three- to six-month loans of $1,000 to $600,000 to help merchants buy inventory. It makes money on interest and takes a cut of all sales on its marketplace, which now account for about 40 percent of total Amazon site sales.


Amazon said it has offered hundreds of millions of dollars in loans since 2012, with more than half of its sellers opting for a repeat loan. The company declined to provide specific figures and also did not say how much it plans to lend this year.


Amazon’s Faricy said the company has become better at understanding the inflection points in a small or medium business where capital can make a difference.


“We know a lot about our sellers’ business and invite only those who we think are in the best position to take capital and grow,” he said.


Faricy said Amazon uses internal algorithms to choose sellers based on the frequency with which they run out of stock, the popularity of their products and their inventory cycles.


In China, where Alibaba lends to small businesses, offering such loans is more of a business requirement, analysts said.


“Amazon has very little share in China and they haven’t been able to break out of that, so this is a very important necessary step for them to be able to grow,” said Gil Luria, analyst with Wedbush Securities in Los Angeles.


In other countries including India, where there is a scramble to expand the online shopping market, small business loans could offer a distinct competitive advantage, Luria said.


 


MITIGATING RISK


Online lending accounts for about 3 percent of the roughly $1 trillion of outstanding personal and small business loans in the United States.


The default rate for small businesses with credit under a $1 million stood at 1 percent in 2014 but is seen rising to 1.6 percent in 2015, as new lenders with varying ability to assess risk increase lending, according to small business credit ratings provider PayNet.


Retailers like Amazon do not have data from sellers about some markets in which they operate, and relying on internal seller company data is not enough, said William Phelan, president of PayNet.


Amazon said it has the information it requires to make “great loan decisions” because of close relationships with sellers and that it mitigates risk by taking loan payments from proceeds due to sellers for their sales.


Sellers interviewed by Reuters and writing on Amazon forums cited interest rates on Amazon loans ranging from 6 percent to 14 percent, in line with loans from banks and business credit cards.


Stephan Aarstol, chief executive of Tower Paddle Boards, an Amazon seller, said he has taken four loans from the company starting in March 2014 because of the speed and simplicity of the process. It took him five days to get his first loan.


“The problem for a small business owner is not the interest rate, it’s the availability of credit … I can’t grow fast enough,” he said.


($1 = 6.2094 Chinese yuan renminbi)


(Reporting by Nandita Bose in Chicago; Editing by Peter Henderson and Matthew Lewis)


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Monday, June 29, 2015

TopVerdict.com | Callagy Law in the Top 20 Verdicts!

Topverdict.com named us for one of the Top 20 Verdicts in NJ. We are the 4th largest according to their site. You can access the complete list here.


 





































































































AmountPlaintiff’s FirmPlaintiff’s AttorneyCaseCase Type
$106,700,000Alston & Bird, LLPMichael JohnsonMylan Inc. v. SmithKline Beecham Corp.Breach of Contract
Critchley, Kinum & VazquezJohn Michael Vazquez
$90,500,000Levy Konigsberg LLPMoshe MaimonKoshinsky v. Anova Holdings AGWrongful Death

Asbestos
$60,000,000K&L Gates LLPAnthony La RoccoAvaya Inc. v. Telecom Labs Inc.Antitrust
$33,487,500Callagy LawSean CallagyPrussin v. SheldonFraud

Misrepresentation
$19,300,000Laddey, Clark & Ryan, LLPAndrew FraserVisaggio v. DorthePersonal Injury

Motor Vehicle Accident
$17,021,387Greenberg Minasian, LLCLawrence MinasianBaker v. New Jersey TransitPersonal Injury

Motor Vehicle Accident
$15,000,000Niedweske Barber Hager, LLCKevin BarberDavis v. Newark Public SchoolEmployment

Disability

Civil Rights
$13,200,000Stark & Stark, P.C.Michael BruscaEsate of Dwyer v. Harbor View Heatlh Care CenterWrongful Death

Medical Malpractice

Nursing Homes
$9,682,567D’Arcy Johnson Day, P.C.Patrick D’ArcyMazzone v. CzyzewskiPersonal Injury

Motor Vehicle Accident
$8,017,025Laddey, Clark & Ryan, LLPTimonthy DinanTufaro v. Schindler Management Ltd.Personal Injury

Premises Liability
$5,804,402Corradino & Papa, LLCRobert PapaCeglie v. Newport Centre Noc IIIPersonal Injury

Premises Liability
$4,260,000Lynch Lynch Held Rosenberg, P.C.Arther LynchConyers v. SpringPersonal Injury

Motor Vehicle Accident
$4,000,000Kim & Bae, P.C.Roy GoldbergNationwide Management Service LLC v. MP Fashion Inc.Fraud

Breach of Contract
$3,750,000Flynn & Wietzke, P.C.Marc WietzkeMeals v. Port Authority of New York and New JerseyPersonal Injury

Workplace Safety
$3,500,000Cutolo Mandel LLCJeffrey MandelDiaz v. North East Linen Supply Co.Personal Injury

Premises Liability

Workplace Safety

Toxic Torts
Ginarte O’Dwyer Gonzalez Gallardo & Winograd, LLPJohn O’Dwyer
$3,200,000Gill & Chamas, LLCPeter ChamasLattanzio v. Quality Technologies Services LLCPersonal Injury

Premises Liability

Workplace Safety
$3,100,000Law Offices of James C. DeZao, P.A.James DezaoQuarcoo v. LiPersonal Injury

Motor Vehicle Accident
$2,897,955Cerussi & Gunn, PCCharles CerussiKwityn v. Port Authority Trans-Hudson Corp.Personal Injury

Premises Liability
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TopVerdict.com | Callagy Law in the Top 20 Verdicts!

U.S. Airs Deep Concerns Over Cyber Security | Callagy Law

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Callagy Law | Quote of the Day

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Friday, June 26, 2015

Google, GE get the most face time when lobbying the EU

By Julia Fioretti


BRUSSELS (Reuters) – Google and General Electric are some of the most active companies lobbying the European Commission, the anti-corruption group Transparency International said on Wednesday.


In a report analyzing meetings held by European Commissioners and their staff with companies and organizations over the last six months, Transparency International found that officials held 29 meetings with the U.S. search engine, which is the subject of two high-profile antitrust cases.


General Electric, which is trying to get EU approval for its bid for Alstom’s power division, had 26 meetings with senior officials, according to the report.


“GE is a large industrial and technology company with broad interests that impact healthcare, transportation, consumer products, energy, finance and many other industries. We are also actively engaged with the European Commission on our proposed alliance with Alstom,” GE spokesman Seth Martin said in an emailed statement.


A spokesman for Google said: “As we’ve said before we want to do a better job of listening to Europe’s concerns and explaining how our business works in Europe.”


The new EU executive, which took office in November, has pushed for more transparency in its dealings with companies and organizations and has begun publishing details of meetings held by senior officials.


The EU also tracks how much companies and organizations spend on lobbying activities, which is published in its Transparency Register.


Google spent between 3.5-3.8 million euros ($3.92-4.26 million) in lobbying activities last year, according to the register, while GE has not entered an amount for 2014. In 2013, it spent between 3.25-5.5 million euros.


Transparency International’s report found that more than 75 percent of meetings were held with corporate lobbyists, compared with 18 percent with non-governmental organizations and four percent with think tanks.


“The evidence of the last six months suggests there is a strong link between the amount of money you spend and the number of meetings you get,” said Daniel Freund, a policy officer at Transparency International, referring to the EU’s Transparency Register.


Transparency International listed the top 10 organizations by number of meetings, which included environmental campaign groups WWF and Greenpeace.


Officials working in the fields of climate, energy, finance and digital policy got the most attention from lobbyists, Transparency International’s report said.


(Reporting by Julia Fioretti. Editing by Jane Merriman)


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Callagy Law | Quote of the Day

Callagy Law’s quote of the day is a daily post to help all of our readers and followers get the motivation they need to get through the day, week, and month. You can see more on the Callagy Law blog page here.


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Thursday, June 25, 2015

Callagy Law | Quote of the Day

Callagy Law’s quote of the day is a daily post to help all of our readers and followers get the motivation they need to get through the day, week, and month. You can see more on the Callagy Law blog page here.


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Google launches free streaming service ahead of Apple Music debut

By Yasmeen Abutaleb


SAN FRANCISCO (Reuters) – Google Inc launched a free version of its music streaming service on Tuesday, as it sought to upstage the debut of Apple Inc’s rival service next week.


Google Play Music has offered a $9.99 per month subscription service for two years but Tuesday’s launch is the first free version of the streaming service. It is available online and will be available onAndroid and iOS by the end of the week, Elias Roman, Google product manager, said.


Apple said earlier this month it would launch a music streaming service on June 30 for $9.99 per month along with a $14.99 per month family plan, with a free three-month trial.


As with other streaming services, such as Spotify and Rhapsody, Google Play Music curates playlists. Users can tailor playlists based on genre, artist or even activity, such as hosting a pool party or “having fun at work.”


“We believe this is a play that will expose a lot of people to the service,” Roman said in an interview.


Unlike Google’s subscription music service, the free service will carry ads, be unavailable offline and exclude certain songs.


Roman said millions of people look at Google Play Music each month but are not ready to pay for a subscription. By offering a free version of the service, he said, the search engine hopes more people will be compelled to pay for an upgraded version.


Ted Cohen, managing partner of TAG Strategic, a digital entertainment consultancy, said the timing of Google’s launch was strategic.


“It’s a smart time to do it with all the attention around Apple,” Cohen said. “If they did it absent the Apple service, it wouldn’t be the same story.”


Google declined to say how many subscribers it has but said they more than doubled in 2014 from the previous year. But rivals Pandora, Spotify and Beats Music had far more mobile downloads than Google Play Music in 2014, according to data from analytics firm App Annie.


(Reporting by Yasmeen Abutaleb)


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Wednesday, June 24, 2015

Google Genomics adds Broad Institute"s DNA analysis toolkit

NEW YORK (Reuters) – Google Genomics, the cloud-based computing business that is racing to increase its share of online DNA analytics, on Wednesday began offering a cloud service version of the popular DNA analysis software from the Broad Institute, a biomedical research organization.


The Google Inc research tie-up comes as academic institutions and healthcare companies are choosing between Google and other technology companies, like Amazon.com Inc, Microsoft Corp andInternational Business Machines Corp, to host and analyze genetic databases as they look to cure diseases. That sector could be worth $1 billion by 2018, analysts say.


The Broad Institute is made up of scientists from Harvard University, MIT and Harvard-affiliated hospitals. Its Genomic Analysis Tool Kit, or GATK, is used to analyze genomic sequencing data and has been downloaded 20,000 times by researchers and businesses, Broad’s Chief Operating Officer Samantha Singer said in an interview.


Learning how to use the software is complicated and is taught as part of academic biomedical curricula.


The service will take over configuring the technical specifications and demands of the software, Google said. It said it has not yet set a price for the service and will include it in its cloud computing fees at the start.


The agreement is the first of its kind but is not exclusive, the companies said.


(Reporting by Caroline Humer; Editing by Nick Zieminski)


Read more here.


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Callagy Law | Quote of the Day

Callagy Law’s quote of the day is a daily post to help all of our readers and followers get the motivation they need to get through the day, week, and month. You can see more on the Callagy Law blog page here.


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Monday, June 22, 2015

Callagy Law Firm

Facebook Gaining Ground on YouTube in Video Ads

By Eric Auchard and Leila Abboud


FRANKFURT/PARIS (Reuters) – Facebook <FB.O> is gaining ground on Google’s <GOOGL.O> YouTube as an outlet for big companies to market their products via online videos, the fastest growing category of Internet ads, a report published on Monday said.


The competition for video viewers opens up a new front in the clash between the two web giants that already compete in other types of advertising given their appeal to young and international consumers, Ampere Analysis said in a study.


London-based Ampere predicts a new advertising “arms race” between the two rivals, neck and neck in terms of audience sizes with around 1.4 billion to 1.3 billion monthly active users, respectively for Facebook and YouTube. That means consumers are likely to be forced to see more ads, but also enjoy a richer range of video programming as a result, it said.


The Internet will overtake TV advertising in 12 key markets, representing 28 percent of global ad spending by 2017, separate research by media-buying firm ZenithOptimedia said on Monday. Ad spending is projected to reach $531 billion this year.


Online video is now growing faster than any other digital category or subcategory, rising 33 percent in 2014, and is forecast to grow 29 percent a year through 2017, Zenith said.


The two reports were released as the week-long Cannes Lions international advertising conference opens this week.


Ampere Analysis argues that Facebook is morphing from a platform most advertisers use for building general brand awareness to one that can deliver “pre-roll” advertisements that marketing companies prefer for ensuring their messages are actually viewed.


Currently, YouTube remains a more flexible marketing platform, offering advertisers the full range of video ads which run before, during or after a video program is shown.


“If the social network’s own video ambitions are to be realized, and if it is to convince content owners it is a viable alternative to YouTube, it must deliver comparable returns,” Ampere Research Director Richard Broughton said.


Differences in ad formats translate into the rates the Internet platforms can charge advertisers. While YouTube charges advertisers when an advertisement has been viewed, Facebook offers the less advertiser-friendly model of charging once three seconds of the video have been delivered, Ampere noted.


Most content providers now use Facebook for branding and awareness purposes, but trial revenue-sharing deals with the National Football League and Fox Sports in the United States pose a serious challenger to YouTube’s lead, said Ampere, a research firm that serves media companies and investment banks.


(Editing by Keith Weir)


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Callagy Law | Quote of the Day

Callagy Law’s quote of the day is a daily post to help all of our readers and followers get the motivation they need to get through the day, week, and month. You can see more on the Callagy Law blog page here.v


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Friday, June 19, 2015

U.S. employee data breach tied to Chinese intelligence



By Joseph Menn


SAN FRANCISCO (Reuters) – The Chinese hacking group suspected of stealing sensitive information about millions of current and formerU.S. government employees has a different mission and organizational structure than the military hackers who have been accused of other U.S. data breaches, according to people familiar with the matter.


While the Chinese People’s Liberation Army typically goes after defense and trade secrets, this hacking group has repeatedly accessed data that could be useful to Chinese counter-intelligence and internal stability, said two people close to the U.S. investigation.


Washington has not publicly accused Beijing of orchestrating the data breach at the U.S. Department of Homeland Security’s Office of Personnel Management (OPM), and China has dismissed as “irresponsible and unscientific” any suggestion that it was behind the attack.


Sources told Reuters that the hackers employed a rare tool to take remote control of computers, dubbed Sakula, that was also used in the data breach at U.S. health insurer Anthem Inc last year.


The Anthem attack, in turn, has been tied to a group that security researchers said is affiliated with China’s Ministry of State Security, which is focused on government stability, counter-intelligence and dissidents. The ministry could not immediately be reached for comment.


In addition, U.S. investigators believe the hackers registered the deceptively named OPM-Learning.org website to try to capture employee names and passwords, in the same way that Anthem, formerly known as Wellpoint, was subverted with spurious websites such as We11point.com, which used the number “1” instead of the letter “l”.


Both the Anthem and OPM breaches used malicious software electronically signed as safe with a certificate stolen from DTOPTOOLZ Co, a Korean software company, the people close to the inquiry said. DTOPTOOLZ said it had no involvement in the data breaches.


The FBI did not respond to requests for comment. People familiar with its investigation said Sakula had only been seen in use by a small number of Chinese hacking teams.


“Chinese law prohibits hacking attacks and other such behaviors which damage Internet security,” China’s Foreign Ministry said in a statement. “The Chinese government takes resolute strong measures against any kind of hacking attack. We oppose baseless insinuations against China.”


MANY UNKNOWNS


Most of the biggest U.S. cyber attacks blamed on China have been attributed, with varying degrees of certitude, to elements of the Chinese army. In the most dramatic case two years ago, the U.S. Justice Department indicted five PLA officers for alleged economic espionage.


Far less is known about the OPM hackers, and security researchers have differing views about the size of the group and what other attacks it is responsible for.


People close to the OPM investigation said the same group was behind Anthem and other insurance breaches. But they are not yet sure which part of the Chinese government is responsible.


“We are seeing a group that is only targeting personal information,” said Laura Gigante, manager of threat intelligence at FireEye Inc, which has worked on a number of the high-profile network intrusions.


CrowdStrike and other security companies, however, say the Anthem hackers also engaged in stealing defense and industry trade secrets. CrowdStrike calls the group “Deep Panda,” EMC Corp’s RSA security division dubs it “Shell Crew,” and other firms have picked different names.


The OPM breach gave hackers access to U.S. government job applicants’ security clearance forms detailing past drug use, love affairs, and foreign contacts that officials fear could be used for blackmail or recruiting.


In contrast to hacking outfits associated with the Chinese army, “Deep Panda” appears to be affiliated with the Ministry of State Security, said CrowdStrike co-founder Dmitri Alperovitch.


Information about U.S. spies in China would logically be a top priority for the ministry, Alperovitch said, adding that “Deep Panda’s” tools and techniques have also been used to monitor democracy protesters in Hong Kong.


An executive at one of the first companies to connect the Anthem and OPM compromises, ThreatConnect, said the disagreements about the boundaries of “Deep Panda” could reflect a different structure than that in top-down military units.


“We think it’s likely a cohort of Chinese actors, a bunch of mini-groups that are handled by one main benefactor,” said Rich Barger, co-founder of ThreatConnect, adding that the group could get software tools and other resources from a common supplier.


“We think this series of activity over time is a little more distributed, and that is why there is not a broad consensus as to the beginning and end of this group.”


(Reporting by Joseph Menn in San Francisco; Additional reporting by Jeremy Wagstaff in Singapore, and Ben Blanchard and Paul Carsten inBeijing; Editing by Tiffany Wu)



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Traders bet on Twitter near-term gains as takeover chatter persists



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By Saqib Iqbal Ahmed


NEW YORK (Reuters) – Dick Costolo’s decision to step down as Twitter Inc’s chief executive last week failed to stem the weeks-long slide in the company’s shares, but options traders appear to be betting on a near-term rebound.


The stock has shed more than a third of its value since Twitter reported first-quarter results in April. It edged up 6 cents to $34.62 on Thursday, after touching a year-low of $33.51 on Tuesday.


On June 11, Costolo said he would resign as CEO under pressure from investors frustrated by the microblogging company’s slow growth, but the move failed to prop up Twitter’s shares.


Options traders seem to be focusing on the near-term and may be looking for something like a takeover bid to make the stock jump, strategists said.


“It seems that everyone and their uncle is betting that Twitter will be bought by another firm,” said Steven Place, founder of options analytics firm investingwithoptions.com in Destin, Florida.


Since May, open interest in calls, usually used for bets on the shares rising, has swelled at a faster pace than the open interest in puts. For every open put contract, 1.7 calls are open, the most bullish for this ratio since early March.


Traders have bid up near-dated options, with the demand for upside reflected in options skew – the difference between expectations for volatility priced into puts versus calls.


Normally, puts tend to have a higher premium relative to calls, because people are willing to pay more to protect against risk of losses. For Twitter, calls have become more expensive than puts.


“The upside skew in Twitter most likely reflects the possibility of an upside event between now and July expiration,” Place said.


That might not necessarily mean that traders are bullish on the stock, but it does suggest investors want to own upside calls in case of a takeover, said Pravit Chintawongvanich, derivatives strategist at Macro Risk Advisors in New York.


Twitter’s second-quarter results, due toward the end of July, could be another reason for near-dated options to be bid, Chintawongvanich said. The stock is usually volatile after reporting results, with average one-day moves of 15 percent.


That co-founder Jack Dorsey is taking over from Costolo only on an interim basis has left some analysts wondering if it is a signal for a potential acquisition of the company.


Twitter has denied that it is in talks to be acquired.


(Reporting by Saqib Iqbal Ahmed; Editing by Richard Chang)






 


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How Relevant Are You? SEO, Alexa Ranking, and Google PageRank

The world of digital marketing is changing almost daily. With new tools emerging, technology changing and becoming more advanced, and algorithms changing, it is important to stay current with your entire marketing strategy; this includes SEO.


One aspect of SEO I have always found intriguing is the world of rankings. There are two ranking specifically as marketers we should be looking at regularly; Alexa and Google Page Rank.


Alexa bases it ranking system based off of the browsing behavior of visitors globally. These traffic ranks are updated on a daily basis. A website’s ranking is determined off of two factors; Pageviews (the total of URL requests from a site) and Unique Visitors (unique users on a site). Keep in mind that multiple requests for the SAME URL are only counted as one pageview. A website that has the highest number of pageviews AND unique visitors is ranked #1 by Alexa’s Ranking System.


Google Page Rank determines the relative importance of a website. Relevant pages receive higher PageRanks and are pages that are appearing at the top of search results. Google takes into account hundreds of factors when determining your website’s PageRank score. Each site is given a PageRank score of 0-10 (10 being the best). Google also basis its score off of the overall “user experience.” Providing quality backlinks also helps improve rankings; In addition the user’s overall behavior is also a major factor. Google factors in aspects like; the amount of time people are spending on your site and if the user finding what they are looking for. Sites with “high scores” are deemed important or relevant by Google’s standards.


Key  Things To Remember:


  • SEO affects everything in a site. It directly impacts your rank.

  • When the SEO is done correctly and more original content is being added to the site on a regular and consistent basis, the site comes up in more search results that the keywords and content relates to.

  • Additionally, the sites popularity grows, due to visitors coming to the site and spending more time on each page (this increases ‘Pageviews’).

  • Increase internal and external links that will cause the visitor to click on those links for more info. These internal links are critical to increasing the measure of time a user spends on a page/site.

  • Rank will improve when visitor count increases. (Ensure Google Analytics is enabled and you are readily checking your GA Reports).

  • When your site becomes more relevant, the lower your Alexa rank gets, and the higher your Google PageRank, because more people are finding your site.

  • Focus on building a good user experience, focus on creating a user friendly environment on the site, the better results you will see.

 


To check your Alexa Ranking, click here.


To check your Google PageRank, click here.


To get started with Google Analytics, click here.


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Callagy Law | Quote of the Day

Callagy Law’s quote of the day is a daily post to help all of our readers and followers get the motivation they need to get through the day, week, and month. You can see more on the Callagy Law blog page here.


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Thursday, June 18, 2015

Callagy Law | Quote of the Day

Callagy Law’s quote of the day is a daily post to help all of our readers and followers get the motivation they need to get through the day, week, and month. You can see more on the Callagy Law blog page here.


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Wednesday, June 17, 2015

Callagy Law | Quote of the Day

Callagy Law’s quote of the day is a daily post to help all of our readers and followers get the motivation they need to get through the day, week, and month. You can see more on the Callagy Law blog page here.


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Monday, June 15, 2015

Callagy Law | Quote of the Day

Callagy Law’s quote of the day is a daily post to help all of our readers and followers get the motivation they need to get through the day, week, and month. You can see more on the Callagy Law blog page here.


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Friday, June 12, 2015

PIP Carriers Cling to Rates for ER Charges

Historically, No Fault insurance carriers, also known as Personal Injury Protection (PIP) Insurers, applied an inappropriate fee schedule to hospital facility charges.  Because no hospital fee schedule existed prior to 1/4/13, PIP carriers often paid hospitals at rates applicable to physicians, not hospitals.  Over the past several years, this practice has been challenged by Callagy Law with tremendous success for hospitals across the state.  Despite the overwhelming success of this challenge to PIP carriers’ improper application of the physician fee schedule rates to hospitals, PIP carriers, to this day, cling to the Physician Fee Schedule in whatever way they can, especially in the area of Emergency Room radiology.


In this effort, PIP carriers rely upon a response by the Department of Banking & Insurance (DOBI) to a Frequently Asked Question or FAQ, in which DOBI explained,


If the patient is referred by a physician simply to have an imaging study performed at a hospital outpatient department, the fees with the TC modifier on the Physician’s column of [The Physician’s Fee Schedule] apply.


This FAQ is commonly known as FAQ 20, and, despite the carriers’ ongoing drumbeat that this FAQ supports their position, the plain meaning of the language, as well as DOBI’s intent, provide no such support, and numerous DRPs (Dispute Resolution Professionals, also known as arbitrators)—in fact the great majority of DRP’s–confirm this.


For the carriers to be correct that the above FAQ supports the application of the Physician Fee Schedule to ER radiology services requires that either  (1) the ER patient is not a patient of the hospital, or (2) the “radiology department” is independent of the hospital.  Indeed, the language in the FAQ requires one of these two circumstances for the carriers’ position on ER radiology to be supported by the language above.  If the patient is already a patient of the hospital by being admitted to the ER, it cannot be a “referral” to the radiology department unless the radiology department is somehow independent of the hospital.


Nothing in common sense supports the proposition offered by the carriers.  Of course the ER patient is a patient of the hospital and to suggest otherwise is ludicrous.  Of course the radiology department is part of the hospital and not independent.  If they were independent of the hospital, how and why would the hospital be billing for the services on its UB with its Tax ID #?  If the radiology machine was owned and operated by an independent entity, the carrier would be receiving a bill for those services from the other entity.  Have they?  Of course not.  It is the hospital that is providing the ER equipment, whether done so in the ER room itself or elsewhere.  Are the carriers seriously suggesting that the hospital is referring a patient to itself?


And why is ER radiology being singled out here for some sort of negative treatment by carriers, when there is literally no support for it?  Is it a “referral “when a patient admitted for in-patient treatment gets an X-Ray at the very same hospital?  Of course not.  Is it a “referral” when the ER nurse tells a technician to administer oxygen or to take blood?  Of course not.  It is all part of the ER encounter, no different than when the X-Ray technician brings the patient to a room across the hall, or down the hall, or to another floor to get an X-Ray.  Why is it different if they left the room?  If they did not leave the room, it is ER treatment, but if they were brought upstairs to the “Radiology Department” the service loses its place in the world of emergent care?  When they are brought up to the OR to get stitched up, is it a “referral” to the “Operation Department”?  Of course not.


Since when are actions or services administered from one part of the hospital to another “referrals”?  Suddenly—out of thin air—sending an ER patient from the four corners of the “Emergency Room” to another part of the hospital—still receiving emergent treatment mind you—is now somehow a “referral.”


How can anyone point to FAQ 20 for support here?  FAQ 20 clearly describes non-patients of the hospital coming to the hospital SIMPLY  for radiology.  It is susceptible of no other interpretation.


The correct interpretation of FAQ 20 is the much simpler one that is supported by the plain language of the FAQ and the clear intent of DOBI.  The threshold question quite simply is:


Is the patient receiving the radiology a patient of the hospital?


If not, as per FAQ 20, the hospital is to be reimbursed at Exhibit 1, Physician Fee Schedule rates, which is a perfectly reasonable position, because the hospital, in this case, is serving strictly as an imaging center for the physician, no different from any other imaging center.


If, however, the patient receiving the radiology services is a patient of the hospital, the question becomes what type of patient:


  1. If admitted for in-patient treatment, UCR applies;

  2. If admitted for Outpatient Surgical Treatment, Exhibit 7 HOSF rates apply to the radiology:

  3. If admitted for Emergency Room treatment, UCR applies.

Each one of the above scenarios is founded on sound public policy considerations, especially when it comes to ER services.  ER services are critical to any modern civilized society.  Above all other medical services, ER services are absolutely essential and must be fostered, encouraged and promoted.  The same policy considerations that paid trauma physicians at UCR rates historically are at work here.  The same policy concerns that pay ER physicians at 150% of Exhibit 1 are at play here.  The same policy considerations that led DOBI to exempt ER surgery services from Exhibit 7 in the first place are at work here.  You do not discourage through lower reimbursements the very activity you want to promote.


In short, the PIP carriers’ stubborn clinging to the Physician’s Fee Schedule rates for ER radiology is supported by nothing—not the plain language of FAQ 20, not the intent of DOBI, and not any semblance of common sense.


 


 


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Important Information Regarding DOBI

In order for hospital Emergency Room (ER) services to be reimbursed by No Fault (Personal Injury Protection or PIP) insurance carriers at the hospital’s usual and customary rates (UCR), the services must fall within the exemption, carved out by the Department of Banking & Insurance (DOBI) in its PIP regulations.  That exemption states:


The non-physician facility fees in subchapter, Appendix, Exhibit 7 [the hospital outpatient fee schedule] shall not apply to services provided in hospital emergency rooms. The bills for these services shall use the modifier “-ER”.


 


Some Dispute Resolution Professionals (DRP’s), also known as arbitrators, interpret the word “shall” as being mandatory, that is, if the two initials “ER” do not appear after the CPT Codes on the bill, the Exhibit 7 HOSF rates apply, rather than the usually higher UCR rates. DOBI’s intent, these DRP’s reason, is that use of the modifier is not optional or permissive.  If it were, DOBI would have used the word “could” or “can,” rather than the stricter “shall.”  Ironically, these DRP’s undercut DOBI’s intent, rather than promote it.


 


Let me state at the outset, that it is the position of Callagy Law, supported by the commentary surrounding adoption of the exemption, that the modifier only applies to the surgical codes themselves, not any of the other codes growing out of an ER encounter, the purpose being to distinguish surgeries pursuant to ER treatment (reimbursable at UCR) from other outpatient surgeries (reimbursable at Exhibit 7 rates).  Nevertheless, some DRP’s look to the modifier as necessary for all codes, not simply the surgical codes.  In either event, they are incorrect.


 


The intent of the exemption is to make clear that in enacting the Hospital Outpatient Surgical Facility Fee Schedule DOBI did not intend to include ER treatment.  Indeed, at times, ER treatment is considered outpatient treatment, and so, DOBI wanted to distinguish outpatient surgeries, akin to those performed at ambulatory surgery centers, which would be subject to the Exhibit 7 HOSF rates, with hospital ER services, which have no analogue.  Accordingly, the great majority of DRP’s have determined that the absence of the modifier is not fatal to a claim for UCR, because the bill clearly uses other indicators that the treatment was ER treatment.  Indeed, ER bills usually state on their face “Emergency Room” before the main ER evaluation code (9928X).  The clinical records, moreover, are usually dispositive as to whether the encounter was an ER encounter or not.  It is usually quite obvious from both the bills and the clinical records that treatment is ER treatment.


 


Yet, a small minority of DRP’s will ignore the obvious and pin their conclusion on the notion that DOBI “intended” the modifier to be mandatory.  Let’s examine that.


 


Was DOBI’s intent with the exemption to create a new modifier?  Was it somehow to strengthen use of modifiers in hospital billing practices, and, therefore, not using the modifier would deny a hospital what is usually a higher rate of reimbursement?  Of course not.  The intent of DOBI with the exemption was to allow UCR reimbursement of hospital ER charges, and use of the modifier seemed like a good way to convey to the carrier that the encounter grew out of the ER.  Otherwise, you would think DOBI would have stated consequences for failure to use the modifier, but it doesn’t. If by all indications the services were part of ER treatment, but, because of failure to use the modifier, the hospital loses the benefit of the exemption, DOBI’s intent to reimburse the services at UCR is clearly undermined.


 


How do you reconcile use of the word “shall” with the idea that the modifier’s use is not mandatory?  Easy.  I read “shall” in this instance as no different from the word “will.”  It is instructive.  Use the modifier ER to convey to the carrier that the services are ER services.  If, however, it is otherwise clear that the services were ER services, the same end is achieved.


 


To deny hospitals the benefit of the exemption because the ER modifier was not used, when all indications from the bill and clinical records is that the services were the result of an ER encounter, does not foster DOBI’s intent—It grossly undermines it.


 


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Thursday, June 11, 2015

Callagy Law | Quote of the Day

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Wednesday, June 10, 2015

Callagy Law | Quote of the Day

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Tuesday, June 9, 2015

Callagy Law | Quote of the Day

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Friday, June 5, 2015

Callagy Law | Quote of the Day

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Thursday, June 4, 2015

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Wednesday, June 3, 2015

Disclaimers and PIP Insurance Benefits

A PIP insurance policy will likely include language requiring the insured to cooperate with an investigation concerning a claim filed for injuries suffered in a motor vehicle accident.  An insurer will have the right to seek information, but this right is not unfettered.  The principal case in this area is New Jersey Auto. Full Ins. Co. v. Jallah, 256 N.J. Super. 134 (App. Div. 1992).  The Court held that discovery disputes are subject to ordinary standards of reasonableness and fairness.


What then is “reasonable and fair”?  This often arises when someone is injured in a motor vehicle accident, but does not have their own PIP insurance.  In this instance, the patient may seek benefits under someone else’s policy.  Let’s say the patient was a passenger in a vehicle when an accident occurred, and files a PIP claim under the insurance policy of the driver of the vehicle.  The insurer will likely want to conduct an investigation to make sure there is not another PIP policy that would be primary in such a scenario.  For example, if that patient lived with a relative at the time of the accident, and that relative had PIP insurance, that policy would be primary to the driver’s policy.  An insurer would have the right to conduct reasonable discovery to determine answers to this line of question.


Do not ignore mail from your insurance company!  A PIP insurer may request that you appear for an Examination Under Oath (“EUO”).  If you receive a letter from the insurer requesting that you appear for an EUO, read the letter.  If you have an attorney handling a liability claim concerning the accident, promptly provide a copy of the letter to that attorney.


Next, determine if you are available at the time requested for the EUO and if you are able to appear.  If you have a conflict, let the insurance company know you are unavailable at the time requested.  You should provide such information in writing, and in a way you can someday prove that you did respond to the insurer.  If you agree to an alternative time with the PIP insurer, make sure to keep this appointment.  If something happens and you cannot appear for this EUO either, make sure you contact the insurer (again in a way that can be confirmed someday) and reschedule another time.


It is important to recognize a failure to cooperate can result in a disclaimer of PIP benefits.  If this happens, the patient will be responsible for the bills incurred pursuant to the New Jersey PIP fee schedules and regulations.


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Tuesday, June 2, 2015

Callagy Law | Quote of the Day

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Monday, June 1, 2015

Callagy Law | Quote of the Day

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