Compensation third party

Because closure and postclosure activities can be very expensive, the TSDF standards require owners and operators to demonstrate financial assurance. These provisions also require all TSDFs to set aside funds in order to compensate third parties for bodily injury and property damage that might result from hazardous waste management operations. 

If railroads are subject to strict liability to bystanders then the benchmark model would apply. This optimal result will not necessarily occur under a regime of negligence. Courts will define due care as consistent with the social>welfare maximizing level of preventive effort x). If the railroad provides this level of preventive effort or a higher level it will not be liable to compensate third parties. If it provides less preventive effort it will be liable. Therefore, the decision rule on the level of preventive effort is ... 

Under the new petroleum UST regulations, financial assurance (between ca. 0.5 and 1 million USD per occurrence or between 1 and 2 million USD for aggregate coverage) is required to cover both the cost of any required corrective action, and compensation for third-party liability from accidental release. State and federally owned facilities are exempt from these requirements. 

Exploitation of remote gas fields requires infrastructure and access to land that may affect third parties. In those cases where land-lease is compensated in kind some percentage of the gas is handed over to the transit country (herein referred to as option gas). Concerning security, two immediate issues appear a) how the option gas fits to local energy plans and b) the economic and social stability of the transit country. To some extent b) relates to a) provided the implementation proves successful. 

Before Dr. Brouchard can begin providing these services, he wants to make sure that his program is financially feasible. To do this, he needs to explore ways to be compensated for his services. He is familiar with being compensated for durable medical equipment, so he knows the pharmacy can bill for blood glucose meters, but he has never tried to bill third-party payers or patients for other types of services. 

Compensation traditionally is provided by a patient (e.g., first-party payer) or by an insurance carrier (third-party payers). With first-party payers, the fee for the service is requested directly from the patient. There are advantages and disadvantages to charging patients directly for a clinical service. Advantages include the fact that the pharmacist can ask directly for and... 

Each third-party payer may or may not routinely compensate for pharmacist services. Each third-party payer may also have different processes for submitting claims. In general, there are three methods for requesting compensation, including becoming creden-... 

Prior authorization Another way to receive compensation from traditional third-party payers is to contact the payer for prior authorization. When using prior authorization, the pharmacist contacts the insurance company with information regarding the referral and requests approval for compensation before seeing the patient. With prior authorization, the insurance company may indicate how many visits will be approved and which billing codes may be used (Snella et al., 2004). 

When Dr. Brouchard estimated the number of patients with type 2 diabetes, he also took note of their insurance carriers. Since Sun City, Arizona, is a major retirement community with strict age requirements for its residents, it was not surprising that most of the people served by the pharmacy were elderly (Northwest Valley Chamber of Commerce, 2007). Most of the patients with type 2 diabetes had Medicare insurance, followed by a variety of third-party insurance carriers. Because Medicare was the main insurance carrier for his patients, Dr. Brouchard knew he would have to consider compensation strategies for those patients with and without Medicare Part D coverage. 

The type of education or management service offered may also influence compensation. For example, not all third-party payers cover preventive health education services such as weight-loss counseling or smoking cessation. If the service is not covered, the patient is personally responsible for the fees associated with the program. If it is not already known if the insurance carrier will or will not consider these services under the health plan, it would be prudent to contact the carrier before providing the service to a specific patient. In this way, the patient is aware of whether the services will be covered or if the patient will be responsible for the charges. 

Once the value-added service has been designed, fees established, and the method(s) for compensation selected, the pharmacist must learn how to submit claims. When providers submit claims to Medicare, Medicaid, or any other third-party payers, the claim typically is submitted on the CMS Form 1500. One exception to this is the hospital outpatient clinic, which uses CMS Form 1450. On CMS Form 1500, information regarding the submitting entity, referring physician, type of services offered, and related health condition is included. To convey this type of information, CPT codes and ICD-9-CM codes are used. These coding systems provide detailed information regarding the types of services provided and the specific health condition in a numerical format. Example CMS 1500 and 1450 forms are available on the CMS Web site (www.CMS.hhs.gov). 

Several different types of billing mechanisms have been used to gain compensation from third parties for services that are not tied directly to dispensing a drug product. Examples include fee-for-service, capitation payment, and the Health Care Financing Administration (HCFA) 1500 claim form. Each method has inherent advantages and disadvantages and may not be a suitable method for compensation for a comprehensive pharmaceutical care practice. 

Clinical pharmacy evolved into pharmaceutical care, which included therapeutic outcome monitoring and disease-state management to improve quality of life and minimize long-term health costs. Pharmacists are now receiving compensation from third-party payers for such cognitive services and have expanded their clinical skills.There is a move by more and more states to seek prescriptive authority for pharmacists, enabling seamless and effective monitoring and treatment of patients, especially those with chronic diseases on maintenance therapy. ... 

Investigators participating in clinical research must obtain from each subject authorization that accurately describes the uses and potential disclosure of PHI. The authorization (2) may be presented as part of the Informed Consent (see p. 565). In any event, authorization for access to PHI generated prior to research must be obtained from the subject (e.g., past medical history, previous treatments, hospitalizations). The authorization will state who will have access to the PHI and detail the specific duration of the use of the PHI the expiration of use can be referred to a specific event, e.g., an FDA approval. If data will be used as a research database, then an expiration of none might be acceptable to the subjects. The authorization must disclose whether there is compensation to the researcher from a third party and the use or disclosure of the PHI, but the amount of compensation is not required. If the subject revokes the PHI authorization, information already obtained under the authorization may still be used to preserve the integrity of the clinical trial such as marketing application or ADR reporting. If this is the case, no new PHI on that subject may be collected or disclosed. 

If the employee is injured by a third party, the employer usually is required to provide workers compensation coverage, but can be reimbursed for these costs from any settlement that the injured employee receives through legal action or other methods. 

Consequently, it is not surprising that the Chernobyl accident has provoked considerable disqniet abont the adequacy and scope of international liability arrangements for third-party compensation after nuclear incidents. 

Strict liability applies to producers or suppliers of any end product, raw material, or component, as well as to the quasi producers, those who present themselves as producers by affixing their name, trademark, and other distinguishing feature on the product. Losses in the area of consumer goods are more likely producers of industrial products (i.e., machines) will encounter more actions resulting under worker liability claims and compensation. Component producers may also face claims caused by the defective product components of third-party manufacturers. Figure 2-3 describes the product liability terms. 

A workers compensation case automatically involves two parties the employer and the injured employee. In some cases, either party may file a lawsuit about the case against another company or person. The additional company or person is a third party. 

If an injured worker wins a third party lawsuit and receives an award that is larger than that obtained through workers compensation, the worker may have to repay the compensation obtained through workers compensation. The... 

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