Walk. Or Maybe Don’t Walk

Clean transportation at its finest – your legs! But is it worth it? It seems not. Florida and Delaware are the two worst states to go for a walk in according to recent statistics. Recent numbers released by the GHSA (Governor’s Highway Safety Association) say there were almost 6,000 pedestrian fatalities between January and June, 2016. That’s an 11% increase in pedestrian involved deaths on roadways – in the first half of the year! Numbers haven’t increased that much in nearly 40 years.

Researchers blame old roads and outdated designs that don’t make accommodations for today’s car-less society for this rise. “Florida and Delaware don’t have a monopoly on drunk or distracted pedestrians who just happen to be jaywalking in dark clothing,” said a Transportation expert to CNN Tech.

Distracted Pedestrian and Other Tips

To begin with, make sure you know where you’re going and how you’re going get there. As the article mentioned, many roads in Florida are not designed with bicycle and pedestrian travel in mind. Knowing where you can cross busy intersections more safely is the first step. Map out your route with safety in mind.  Also, don’t take unnecessary risks when traveling on foot.  This past year saw many instances of extreme examples involving distracted pedestrians, and drivers, thanks to PokémonGo®.  You can control some risk by being aware of your surroundings and by paying attention. Think, just because it’s my right of way does that mean I will come out the winner if I challenge a 4000 pound vehicle traveling 35 miles an hour? Probably not. Lastly, pay attention to the road signs and always obey pedestrian traffic laws when applicable. Getting there safely starts with you!

If you or a loved has been a pedestrian struck by a vehicle and injured, we’re here to help. The bicycle and pedestrian accident lawyers at Heintz & Becker know just how Meticulous Preparation + Aggressive Advocacy = Achieving Justice for our clients. Call us today for a no-obligation, free consultation.


Hyundai and Kia Announce Massive Recalls Coming

Hyundai and Kia Motors will be recalling nearly 1.5 million cars and SUVs due to engine malfunctions. In the U.S. alone, 1.19 million vehicles are being recalled. The recalled vehicles consist of the 2013 -2014 Hyundai Sonata and Santa Fe, along with the 2011-2014 Kia Optima, 2012-2014 Sorento, and 2011-2013 Sportage. All of the defective vehicles are equipped with 2.0 liter and 2.4 liter engines.

Why Another Recall?

The companies claim that the recall is due to complications with the manufacturing process, rather than the actual design of the vehicles. It is speculated that metal debris left in the crankshafts harm the engine and may cause engine failure. The debris left from the manufacturing processes may suppress the flow of oil to the connecting rod bearings. The lack of oil causes temperature increases which leads to the bearings malfunctioning and eventually leading the engine to stall out, increasing the risk of a crash. Luckily, there have been no injuries or crashes reported from these defects yet.

What Do I Do Now?

Owners of these vehicles should be on the lookout for “knocking” sounds coming from the engine that increases as drivers accelerate. Warning lights may also warn drivers and owners of potential engine malfunctions. The companies announced that the recalls are schedules to begin in May 2017 and will replace consumers’ recalled engines with new ones.


Silicone Breast Implant Advisory

Breast implant complications are once again making news. Last week the FDA announced an increased risk of developing anaplastic large cell lymphoma (ALCL) for women with breast implants. You may recall the previous cancer linked recalls from the early 1990’s of silicone breast implants. Silicone implants were thought to be linked to an increased risk of cancer however, in 2006 the FDA returned them to the market after definitive evidence of a link was not established. There has been backlash and criticism since that time. Even after being made available again, the FDA was warning women of the possible increased risk they faced for developing ALCL if they had breast implants.

The New Developments

This latest announcement from the FDA is the result of an increased number of reports of women with breast implants developing ALCL.  Between summer 2010 and February of this year, 359 reports were logged, including nine (9) deaths. There are reports that state the cancer was diagnosed as early as 1996 in at least one case. The data is limited and the risk of developing this cancer is still considered to be very low. Surface type of the implant (smooth v. textured) and length of time that they are in the body also seem to be factors. Nearly 90% of women who provided data on the type of implants (203 of 231 reports) had textured surface implants. There were an almost identical number of filler solutions (silicone v. saline). While this cancer does occur in and around the breast(s), it does not fall under the category of “breast cancer.”

What Should I Do Now?

Currently there are no recommendations of removal for women who have no symptoms associated with this type of cancer. Those symptoms include:

  • fatigue;
  • fever;
  • loss of appetite;
  • night sweats; and/or
  • weight loss.

If you experience any of the above symptoms and have breast implants, we would encourage you to consult with your doctor. Additional symptoms can include fluid buildup, swelling, pain or lumps. There is often resolution of the cancer once the implants are removed and, depending on the type of ALCL (cutaneous or systemic), other treatment options are available.

Here is a link to the FDA notice regarding these implants and what doctors and patients are advised to do should they notice anything suspect. If you or a loved one has been diagnosed with ALCL after receiving breast implants contact the attorneys at Heintz & Becker for a free consultation and case evaluation.

Sources:

https://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/ImplantsandProsthetics/BreastImplants/ucm064106.htm

http://www.foxnews.com/health/2017/03/27/breast-implants-linked-to-cancer-how-does-it-happen.html


Brazilian Jiu-jitsu – Workout and Self-Defense

Are you looking for a great way to stay in shape but get bored with traditional weight lifting? Brazilian Jiu-jitsu is the perfect way to get fit while learning self-defense techniques that can save your life. There are thousands of Brazilian Jiu-jitsu gyms across the U.S. and in recent years the sport has grown exponentially. People of all ages, sizes, and backgrounds have come to know and love the sport. Celebrities and athletes including Kelly Slater and Ashton Kutcher are avid practitioners. The late Paul Walker and star of The Fast and The Furious was also one of the sport’s biggest enthusiasts.

This martial art is designed to give a smaller opponent the upper hand in self-defense situations against larger opponents. Brazilian Jiu-jitsu focuses on using the larger individual’s weight and height as leverage against them. The beauty of jiu-jitsu is that the submission techniques are generally able to keep both people from suffering serious injury. A simple choke or shoulder lock, which can be mastered by nearly anyone after a few months of training, is very effective and allows the attacker to suffer minimal injury yet leaves them subdued. Even a basic knowledge of a few various techniques can save your life in a dangerous situation.

Aside from the self-defense aspects of jiu-jitsu, there are many other benefits. When you join a jiu-jitsu gym you are joining a family. You are guaranteed to make friends and have great teammates to push you to be the best you can. The beauty of the sport is that it helps people gain confidence and build work ethic that is reflected in their home lives, jobs, and academics. Brazilian Jiu-jitsu is one of the truest sports, bringing diverse groups of people together and helping them collectively better one another.

Lastly, for those of you who love a good rush, there are tournaments all over the country. Competing is a great way to let some adrenaline loose and test your skills against jiu-jitsu practitioners from all over the world. It is also a proven way to grow your game and get better faster.

Overall, if you need something to take your mind off the everyday hustle and bustle, Brazilian Jiu-jitsu is a perfect way to get a great workout and learn lifesaving techniques. There are gyms in nearly every city of every state, so find one near you and see if it can change your life the way it has for many others.


Little Tikes Toddler Swing Recall

Does your child or toddler love to play on swings? If so, you may want to double check that it is not manufactured by Little Tikes™. While this is a normally safe activity, parents should be aware of a very large recall of children’s swings from Little Tikes™.

Recall Notice

The company has recently issued a recall of approximately 540,000 units of their “2-in-1 Snug ’n Secure” pink toddler swings. The company has received over 100 consumer reports of the swing seats breaking. Of these incidents, 39 injuries to children have been reported so far. These injuries include mostly abrasions, cuts, bruises, and bumps to the head. However, hard falls from this defective swing have also caused 2 children to sustain a broken arm. The company attributes these injuries to a defective plastic seat that is susceptible to cracking or breaking, posing a serious falling hazard.

The swings have a pink “T-shaped” restraint in front with a Little Tikes™ logo. The defective units have the model number 615573 molded on the back of the swing seat, along with the manufacturing date code. Per the Consumer Products Safety Commission, swings with manufacturing code numbers 10, 11, 12, or 13 are included in the recall. Swings with the manufacturing date code “9” that also have a molded “43” or higher are also included in this recall.

Little Tikes™ asks that consumers immediately stop using recalled units. The company is offering credit towards the purchase of another Little Tikes™ product as refund. These swings were sold in Walmarts, Toys “R” Us, and many other retailers across the country from November 2009 through May 2014.

If your toddler is a swing enthusiast, be sure to make sure they are not swinging in the Little Tikes™ Snug ‘n Secure. In the unfortunate event that your child is injured due to this defective product be sure to contact the offices of Heintz & Becker at (941) 748-2916 or online at HeintzLaw.com.

https://www.cpsc.gov/Recalls/2017/Little-Tikes-Recalls-Toddler-Swings


The Dangers of Riding in Truck Beds

Many people enjoy the thrill of riding in the bed of a pickup truck. Unfortunately, as fun as it may be, it’s also dangerous.

While 30 states, including Florida, have at least some legislation regarding passengers riding in the beds of trucks, some don’t. In fact, there are 20 states that have no laws against riding in the bed of a truck. This has led to hundreds of deaths and thousands more injuries. Continue reading


Insurance Claims – Industry Problem or Provider Calamity (Part 2)

In the first installment of my insurance nightmare blog, I shared how I had paid an estimated out of pocket cost to my children’s surgical provider without questioning the amount. I also shared some tips on things to do before you sign on the dotted line so to speak that may help make you a more informed consumer. Now I’d like to pick up where we left off, nearly three weeks later, and share another leg of my journey.

The Saga Continues

On December 6, I placed a call to the provider’s office to get a status on my anticipated reimbursement. At that time I was told by the billing clerk that neither insurance policy had paid. I promptly reached out to my ex-husband and asked him to look into the insurance claims. He was able to see that claims had either been filed incorrectly and/or incompletely, as well as in the incorrect order (secondary was billed as primary) and therefore denied. I called the provider again and requested copies of what had been submitted in order to further investigate the lack of payments. I was still trying to be helpful and carry the burden of collecting what we pay for from the insurance company. I was faxed claims for both insurances dated November 11. These were the incomplete and incorrect submissions. Again we offered to assist the provider in claim submission. This offer was repeatedly met with arrogance, defensiveness, dismissiveness and flat rejection of the help. On December 13, an email from a representative of the primary insurance company stated that after the file was researched it was determined that as of that day no claims were submitted. In extreme caution and fairness to the doctor’s office, we believe the claims were still being incompletely and/or incorrectly submitted, not that they were not being submitted at all.
Between December 13 and December 27 phone calls and emails were exchanged between my family members, the insurance companies and the provider’s office. On December 20 the secondary insurance received a claim (subsequently rejected) that still did not include the EOB provided by the primary which would then shift the coverage balance to their policy. The primary insurance had an account representative via telephone on or about December 27, walk the provider’s billing clerk through the submission process and on December 29 an EOB and check were processed by them.
I’ll choose to wrap up here on this part of the series. As you can see, the insurance company isn’t the bad guy here. We have all heard horror stories about how an insurance company has denied coverage that should be covered, or they only paid a small part of the claim and a patient received a bill that they believed should have been covered after the fact. Several factors could contribute to receiving a bill that you did not expect, and some of those are considered insurance fraud and should be reported to the Insurance Commissioner. However, you should also make sure that your provider is not only acting in good faith, but that the staff is properly trained. You should be your own best advocate – especially if they take your money upfront.


No Cost Stress Relief- Meditation

Meditation. When many people think of this word they are likely to be skeptical and have difficulty believing that the age old art can derive many mental and physical benefits. Studies have shown that this practice can lead to lower stress, anxiety, and blood pressure, as well as strengthen the immune system. However, cultural and social stereotypes may be keeping this effective and free resource highly underutilized. Despite what many believe, meditation is not only a religious practice; it has a wide variety of applications that can be beneficial to the body as well. Meditation practices can range from simple breathing techniques to advanced visualization or mantra-based techniques.

Can Meditation Relieve Stress?

Stress and anxiety are two inevitable occurrences that many of us suffer from at one point or another throughout life. It is well known both stress and anxiety can lead to mental and physical health complications, ranging from high blood pressure to clinical depression. While medical research has not drawn a definitive correlation between meditation and improved health, studies have shown a strong cause and effect relationship.

According to WebMD, studies show that individuals that habitually meditate have lower blood pressure and stronger immune systems. Doctors attribute this to the stress reduction aspect of the art. Dr. Charles L. Raisin, M.D. of Emory School of Medicine conducted a study that indicated a few minutes of consistent meditation over a six-week period improved physical and emotional health for participants. The overwhelming result was a reduction in stress, which is a known factor in improving immune systems and overall health. Another study by the University of Wisconsin revealed “higher electrical activity in the left frontal lobe of the brain, an area that tends to be more active in optimistic people, after 8 weeks of training in meditation.” Aside from health improvements, meditation even led to higher levels of concentration in daily life.

Improve Your Daily Life With Meditation

If stress or anxiety is taking a toll on your life, meditation is a free and easy way to reduce these ailments while improving cognitive abilities at the same time. The studies make a strong argument that people can improve their daily life and health by meditating. A simple internet search will return nearly all of the information on this topic someone would need to train their mind in the art of meditation.

http://www.webmd.com/balance/features/meditation-heals-body-and-mind#1


The Rise of Distracted Walking

More and more people are choosing alternate ways to commute. Some rely on public transportation, some bike, and others walk. There are plenty of advantages of being a pedestrian. It’s cheaper than maintaining a car and improves your health.

The rise in pedestrians has led many cities to make it easier to get around on foot. Unfortunately, many of these walkways are right next to busy streets, creating a new problem: distracted walking accidents. Continue reading


Insurance Claims – Industry Problem or Provider Calamity (Part 1)

Have you spent time reviewing your medical bills, insurance claim forms (like the explanations of benefits), or insurance contracts to know if you are really getting what you pay for?

With the Affordable Healthcare Act (“Obamacare”) passage in 2010 and implementation in 2013, reports show more Americans are using health insurance than ever before. With an uninsured percent of less than 10% of Americans, the number of claims submitted to insurance companies has increased as well.

Wouldn’t it be wise then,  as consumers as well as patients, to make sure that in a paperwork and electronic tangle of co-payments, deductibles, covered services, co-insurances and maximum out of pocket expenses, that we make sure nothing slips through the cracks?

I mean, the AHA has more than 2000 pages, and I’m pretty sure my health insurance plan does too! Recently I experienced a billing and insurance claim nightmare I’d like to share in an effort to encourage once again, for each of you to always be your best healthcare advocate.

The Story Begins…

As a divorced parent, insurance claims can be a bit more complicated.

My children have coverage from their father and their stepmother. While dual insurance has been a tremendous benefit through the years of braces, bronchitis and broken bones; sports accidents and “boys will be boys” injuries, it also adds a layer of confusion.

Which is primary?

What percentage gets paid?

Which contracted rate (assuming a payer contract was signed) and allowable amount apply to the services provided?

It’s overwhelming at best. Suffice it to say, however, that with the kids nearly grown and almost a decade of experience, we have gotten a pretty good handle on this aspect of co-parenting.

One thing insurance companies may provide is online access to benefits; most even offer a “pre-authorization” estimate for your out of pocket costs.

On the day of the procedures, November 7th, I was quoted an out of pocket amount due to the provider and promptly paid that amount (over $1,500.00).  When the children’s father learned the amount, he questioned it; based on his research on the insurance portals, our out of pocket should not have exceeded $250.00.

We were informed that only one of the available insurances would be billed and that was why the amount was so high. Without hesitation we agreed to file the secondary claim ourselves.

Providers are given certain information for the purpose of submitting claims not available to patients. Four days after the procedures, my former spouse went to the office, with the completed paperwork, to get their signature and other information.

After some questions about the billing process, the conversation became less than amicable. The surgeon intervened and offered for his office to complete the billing for both. This seemed to be a good idea and it was left with them to handle.

Life Lessons

This is a good place to push pause. Trusting the professionals is a lesson many of us were provided by parents and well-meaning mentors at a young age, but this might not always be the best advice. I’ve learned to follow a slightly different method – trust, but verify.

On November 11th, we agreed to trust the professional. More than sixty days later, I am still not financially whole, we’ve traveled down a less than pleasant road with our children’s healthcare provider, and now I’m faced with the dilemma of trusting my gut or trusting the professional. All because I have chosen to trust, but verify.

I’d like to offer my take on where I fell short in this process.

First, I should have been prepared with my own copies of the estimated benefits. Knowledge really is power and in this particular instance, the knowledge was available to me and I was not prepared with it.

Second, I should have asked the provider to provide me the information they received estimating benefits payable that was used to calculate my estimated out of pocket. This is when I would have learned about the difference in the amount billed to me, the amount submitted to the insurance company (-nies) and the negotiated and allowed amounts.

Then, I would have been prepared to negotiate what I was made to pay up front. Less money out of pocket may have made this extended timeframe without reimbursement much more palatable.

Next time

In my next installment, you’ll learn about balance billing, incomplete or inaccurate claim submissions and insurance denials. If you or someone you know has been injured as a result of someone else’s neglect or you believe you are a victim of insurance fraud or questionable medical billing practices, we may be able to help. Contact our office immediately at 941-748-2916 for a free attorney analysis of your case.


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