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Stephanie Cohen, Scott Golden, Jack Cohen

JULY NEWS FROM GOLDEN & COHEN

Please Help Us Fight ALS (Lou Gehrig's Disease)

Join Us In The Walk For ALS: October 17

By Scott Golden, CFO
Scott@Golden-Cohen.com

Over the course of a lifetime, there are certain events that can change someone forever. For me, that moment occurred when I found out that my cousin, Steven Seiden, was diagnosed with Amyotrophic Lateral Sclerosis. He lived with that disease for 12 years, but finally succumbed in 2002.

I watched him deteriorate, slowly at first and then rapidly. I, like everyone who knew and loved him, felt helpless. But I wanted to be helpful in any way that I could. I visited Steven many times in his final days, and was there for his funeral alongside my entire family.

On that day, I made a decision to become active in the fight against ALS.

Register for the Oct. 17 DC Walk to Defeat ALS

I had made a promise to Steven – not verbally, but emotionally. After his death, I got involved with the ALS Association – DC/MD/VA Chapter, and hosted a gala to raise money to help those stricken by this deadly disease. From that point on, I viewed philanthropy in a whole different way. I made it a priority to give both time and money to this cause, and to other good causes, many that are health-related. I feel that I am a better person for it – and that was the gift my cousin gave me.

Every year in October, I now gather as many friends, colleagues, clients, and family members as possible to participate in the DC Walk to Defeat ALS. It is my way of honoring someone who impacted my life so greatly. I invite you to join me! Mark your calendar now for October 17. I'll meet you at the Old Folklife Festival Area in downtown DC. Sign up here.

In this Issue:

  • Learn more about ALS below.
  • Check out the Email Security Update from Jack Cohen.
  • Are you scheduled for surgery? Make sure you are covered! Learn how to protect yourself in the new chapter from our upcoming book, "You Gotta Laugh: Life in the Trenches of the Health Insurance Business."

From all of us at Golden & Cohen, here's to your good health!

Stephanie Cohen, CEO, stephanie@golden-cohen.com
Scott Golden, CFO, scott@golden-cohen.com
Jack Cohen, COO, jack@golden-cohen.com

Lou Gehrig

What You Need to Know: Understanding ALS

By Christine Kirkley
Director of Fundraising and Community Relations
ALS Association – DC/MD/VA Chapter

Amyotrophic Lateral Sclerosis (ALS) is a motor neuron disease, first described in 1869 by the noted French neurologist Jean-Martin Charcot. Today, it is also known as Lou Gehrig's Disease, for the famous baseball player put a spotlight on the disease in 1939 when he abruptly retired from baseball after being diagnosed with ALS.

ALS has also cut short the lives of other such notable and courageous individuals as:

  • Hall of Fame pitcher Jim "Catfish" Hunter
  • Boxing champion Ezzard Charles
  • NBA Hall of Fame basketball player George Yardley
  • Pro football player Glenn Montgomery
  • Golfer Jeff Julian, golf caddie Bruce Edwards
  • British soccer player Jimmy Johnstone
  • Senator Jacob Javits
  • Former vice president of the United States Henry A. Wallace
  • U.S. Army General Maxwell Taylor
  • Actor Michael Zaslow
  • Actor David Niven
  • Jon Stone, the creator of Sesame Street
  • Television producer Scott Brazil
  • Entertainer Dennis Day
  • Musician Lead Belly (Huddie Ledbetter)
  • Jazz musician Charles Mingus
  • Composer Dimitri Shostakovich and
  • Photographer Eddie Adams

Lou Gehrig

What are the symptoms?

Most commonly, the disease strikes people between the ages of 40 and 70, and as many as 30,000 Americans have the disease at any given time.

A neurodegenerative disease, it usually attacks both upper and lower motor neurons and causes degeneration throughout the brain and spinal cord. A common first symptom is a painless weakness in a hand, foot, arm, or leg, which occurs in more than half of all cases. Other early symptoms include difficulty speaking, swallowing, or walking.

What is the cause?

The biological mechanisms that cause ALS are only partially understood. The only known cause of ALS is a mutation of a specific gene: the SOD1 gene.

This mutation is believed to make a defective protein that is toxic to motor nerve cells. The SOD1 mutation, however, accounts for only 1 or 2 percent of ALS cases, or 20 percent of the familial (inherited) cases.

Familial ALS represents between 5 and 10 percent of all cases. The rest arise spontaneously and mysteriously, making seemingly random attacks on previously healthy adults. ALS can strike anyone at anytime.

What are the treatments?

Physicians have limited choices for treating ALS, and the options that do exist have only come into use within the last 10 years. Studies suggest that patients' length of survival and quality of life are enhanced by night-time breathing assistance early in the course of the disease and by aggressive application of alternate feeding options to assure good nutrition, once swallowing becomes difficult.

At this time, riluzole is the only drug that has been approved by the FDA for treatment of ALS. In clinical trials, riluzole has shown a slight benefit in modestly increasing survival time.

Stem cell and gene therapy are promising areas of research. In a variety of studies, ALS mouse models are being used to develop treatments that may someday lead to similar human clinical trials. Gene therapy is one field of research where The ALS Association is concentrating support for more study.

More significant advances in ALS research have occurred in the last decade than in all of the time since Charcot first identified the disease.

Advances in technology and the genetic revolution are aiding researchers in unlocking the ALS mystery. As more scientists focus on this perplexing disease, the outlook for new understanding brightens each day.

For more information visit www.alsinfo.org.

Click here to learn more about the history of the ALS Association – DC/MD/VA Chapter.


Jack Cohen

Email Security Update
By Jack Cohen, COO
jack@golden-cohen.com

Beginning July 12, 2010, we will enhance our existing e-mail security system and you will notice a few minor changes.

We take protecting your personal information very seriously and continually explore new ways to protect your data. Additionally, new regulations have gone into effect setting stricter standards for the protection of personal information.

The new standards require encryption of all e-mails with records and files containing Personally Identifiable Information (PII). PII is any information that can be used to uniquely identify you with identity or account numbers that could be used for purposes of identity theft or fraud (such as social security, financial account or credit/debit account numbers).

How It Works

Email Security Update

  • Each time one of our associates sends you an e-mail, the message and attachments are scanned for PII by our security system.
  • If the security system determines the e-mail or attachments contain PII, the e-mail is sent directly to our secure mail server.
  • You will receive an e-mail notifying you a secure mail is available for retrieval from Proofpoint, our encryption provider.
  • In this message, click the attachment and your internet browser will take you to a page to view the e-mail.
  • If this is your first login, follow the registration steps to complete your login and retrieve your e-mail. If you have accessed secure mail before, you will only need to enter your password.
  • Your reply to any secure mail will also be automatically encrypted. Any e-mail that does not contain PII will be sent directly to you and will not require a password.

Click here to view screenshots of the notification and retrieval process.

Have questions? Don't hesitate to contact me at jack@golden-cohen.com.



 

YOU GOTTA LAUGH:
Life in the Trenches of the Health Insurance Business

By Scott Golden and
Stephanie Cohen
www.golden-cohen.com

Stephanie Cohen, Scott Golden

This month's health insurance issue:

Linda is having surgery in the morning, but at 4 p.m. the night before she gets a call from her HMO requiring her to post a $400 advance deposit – or the surgery is off. What should she do?

The situation: Our client Linda was scheduled to have surgery using a surgical group that had negotiated fees with her HMO carrier. The evening prior to surgery, however, she was notified that she needed to post a $400 advance deposit before the doctors would perform the procedure. She was told she needed to sign a form stating she would pay whatever fees the carrier would not pay to the doctor.

This came despite the fact that the surgeon was in her HMO network and Linda had gotten the proper referral and authorization from the carrier. In fact, her policy dictates that when a provider has signed a contract with an insurance carrier, the patient is held harmless from all fees associated and cannot be asked for additional payments other than applicable copays, deductibles and coinsurance. In this case, the policy had a $20 doctor copayment and 100% coverage, with no hospital copayment.

Linda called us in a panic, and we immediately called our contact at her HMO. Due to the late hour, she couldn't do anything until the following morning when she would have a representative from provider relations step in. And after a long discussion with the insurance company, the patient did not have to post the deposit and did have a successful surgery.

The solution: Don't assume anything prior to having surgery. Get on the phone and make sure you are covered.

1. Contact the insurance provider and verify all benefits. Always get the name of the representative that you talk to, as well as their department name and number. Try to speak with a supervisor. Also, note the date and time you had the discussion, since all calls are recorded and can be pulled to make sure accurate information was given.

2. Get all pre-authorization agreements in writing. Typically, the doctor's office will call, but you must do this, too, so that you can be sure that everyone involved in the surgery – the surgical center, hospital, anesthesiologist, doctors, etc. – are covered by your health insurance plan.

3. Understand your policy and be clear about the items that you may be required to pay for. Many hospitals, surgical centers, radiological providers and labs will send you a bill in addition to submitting to the insurance company. Remember, you must have the bill go to the insurance company for adjudication (in order to get the bill priced properly so they include discounts). Never pay a bill unless the insurance company has received it first, re-priced, and you have received an evidence of benefits that match the bill.

The painful truth: Insurance carriers, doctors and patients will continue to eek out whatever they can from the health care / insurance system until there are new policies in place that make it clear exactly what the contract is that they are entering into. Quite obviously, the system is broken. A new agreement – in terms of cost, payment, and what insurance covers – needs to be worked out.

If we were the Health Insurance Ambassadors: We would require that all doctors notify the patient about what the exact cost of the surgery will be prior to the procedure. The patient would then have a full understanding of the costs associated with the surgery and the doctor would receive the appropriate payment.

In defense of doctors, we would also change how they take payments. Doctors are the only service providers that do not ask for money up front. They provide a service for free in hopes that they receive payment for services. Perhaps they should swipe a credit card before the procedure or at the time of an office visit.

What are your health insurance nightmares? Send stories to our newsletter editor, hope@inkandescentpr.com.

Newsletter by Inkandescent Public Relations, www.inkandescentpr.com
CEO and Executive Editor: Hope Katz Gibbs
Art Director: Michael Gibbs, Web Developer: Max Kukoy
Copyeditor: Adrianne Hamilton, Proofreader: Micaela Barrett.
For more information send an email to hope@inkandescentpr.com

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