#Outsourcing For Insurance Business

[goteamphilippines]

Outsourcing For Insurance Business

Outsourcing key support roles for your Insurance business is a must, especially since the demand for insurance coverage and risk management services keeps rising.

Highly skilled virtual assistants and global team members can take care of your accounting and payroll, claims processing, data entry and processing, customer success, and tech support needs.

This way, you can focus on scaling your business while ensuring that you and your onshore team never get burned out or overwhelmed. Check out this list of roles we can source for your Insurance business!

[opspayroll]

Essential HR & Payroll Solutions: GOSI Compliance, Employee Benefits, and Contract Rules in UAE

For companies operating within Saudi Arabia and the UAE, efficient administration of payroll and HR is essential to ensure compliance with the local rules and regulations as well as effectively manage employee benefits. This guide provides the basis for the GOSI Compliance, HR payroll solutions as well as the regulations for contracts to help companies navigate the complexities of regulations and help their employees.

Understanding HR Payroll Management in Saudi Arabia & UAE

Effective payroll management system does more than processing salary payments; it also helps ensure the compliance of local laws, improves benefits administration, and enhances overall efficiency. Businesses operating in Saudi Arabia and the UAE are faced with unique challenges when it comes to payroll. These range from figuring out the GOSI system in Saudi Arabia to managing benefits for employees in the absence of limitless contracts for the UAE.

Key Components of Payroll Management Software

Employing payroll software for managing payroll has numerous benefits especially for companies with a variety of employees and complicated needs for payroll. Here are a few key aspects to be looking for:

Automatic Payroll Processing Automating payroll will help to reduce errors, speed up the process and increase accuracy.

Monitoring Compliance is a way to verify compliance with local laws governing labor, like GOSI, which is a requirement in Saudi as well as UAE contract regulations.

Self-Service Portals for Employees allows employees to check their pay details, benefits, as well as leave balances quickly.

Integration with other HR Systems seamless integration with HR systems to automate processes like leave and attendance tracking.

GOSI Compliance in Saudi Arabia

The General Organization for Social Insurance (GOSI) is the social insurance system that is mandatory for Saudi Arabia, covering various benefits for employees including disability and retirement. The compliance with GOSI is vital for all companies operating within the Kingdom.

What is GOSI?

GOSI offers social insurance benefits to Saudi citizens as well as expats who work for private companies. Employers and employees also contribute to GOSI which helps with the retirement benefits, workplace hazards as well as disability and retirement benefits.

Employer's Contribution Employers must contribute 12 percent of the salary of the employee to GOSI in Saudi.

employee contribution Employees can also contribute 10 percent of their wages to GOSI.

The reporting requirement Companies must be able to accurately pay their employees to GOSI each month to ensure that they are in compliance.

Importance of GOSI Compliance

For businesses in Saudi Arabia, maintaining GOSI compliance is not only an obligation of law but crucial to create an environment that is positive for employees.

Avoiding penalties Infractions to GOSI rules can result in sanctions and legal consequences.

Benefits for Employees: GOSI compliance ensures employees are provided with insurance and retirement benefits which improve job satisfaction.

Reputation Management Compliance with GOSI shows that your company is committed to ensuring the security of your employees as well as establishing a positive company image.

HR Payroll Management in the UAE: Limited and Unlimited Contracts

In the UAE the employment contracts are classified by their terms as only and unlimited and have distinct rules for each kind. Understanding these distinctions is essential for companies, particularly when it comes to the calculation of benefits at the end of the service and coordinating the payroll.

Limited Contracts

The limit contract with the UAE is generally a fixed-term contract, with a term of one to three years. It is terminated automatically at the expiration date unless it is renewed.

The End-of-Service Benefits Employees who have contracts with a limited duration can receive a gratuity contingent on the duration of their service.

End of Contract Rules A termination that occurs prior to the expiration date of the contract could result in penalties unless the parties have mutually agreed on.

Renewal Limits and Renewal Renewal Contracts with limited terms can be renewed, however they have stricter rules for renewal and termination.

Unlimited Contracts

A Unlimited contract with the UAE doesn't have an end date fixed and can be ended by either party upon giving notice.

Flexible termination Employers and employees are able to terminate an unlimited contract at any time with notice, which makes this contract flexible.

Gratuity Rights The employees have the right to receive a gratuity in accordance with the number of years they have worked since their termination.

is a common choice for roles that last a long time Unlimited contracts are typically utilized for long-term and indefinite tasks, making them an increasingly popular option for permanent jobs.

Using Payroll Management Software for Compliance and Efficiency

Installing payroll management software will simplify the complicated demands for payroll for Saudi Arabia and the UAE. Here's how:

Automated Compliance Management

Payroll software helps with compliance by staying up-to-date on rules and regulations like GOSI, which is a part of Saudi Arabia and UAE regulations on employment.

Automated Calculation of Contributions It ensures the accuracy of GOSI and employee contributions to employers as well as employees working in Saudi Arabia.

Calculation of the Contract-Specific Gratification Calculates gratuities according to the conditions of limited contracts in the UAE.

Reduces the risk of errors made by manual Automating reduces the possibility of mistakes while ensuring that payroll processing is accurate.

Efficient Employee Benefits Management

The management of the benefits of employees through payroll software enables the administration of benefits to be simplified and improves employee satisfaction and efficiency of HR.

Self-Service Portals for Employees Employees have the ability to see their benefits, balances on leave and pay slips, increasing the transparency of their benefits.

Benefits packages that can be customized Payroll software allows you to handle a variety of benefits for employees including retirement and health insurance.

The Leave Management: Monitors annual absences, sick days, and other absences in order to calculate entitlements with precision.

Ideal for Small Businesses

For payroll firms that cater to small businesses employing tools for managing payroll is crucial to manage benefits and payroll with a limited amount of resources.

Cost-effective Many payroll software choices are designed to be accessible to small-sized companies.

Scalability as the business grows, payroll software is able to be adapted to handle a larger number of employees and the more complicated payroll requirements.

Time-Saving Automates tedious tasks. This frees HR resources to concentrate upon strategic projects.

Employee Benefits in Saudi Arabia & UAE

The provision of extensive employees with a wide range of benefits is essential for employers to keep and attract top talent from Saudi Arabia and the UAE. Here's a list of the most common benefits that are offered:

Health Insurance

Insurance for health is a compulsory obligation to be covered in Saudi Arabia and the UAE, with employers required to offer coverage to their employees.

Saudi The requirement Employers must provide healthcare insurance coverage to employees as well as their families.

UAE Requirements Health insurance is compulsory in all UAE residents. Employers generally cover dependent and employee insurance.

End-of-Service Gratuity

The end-of-service bonus is an important incentive for employees who work in UAE in the UAE and Saudi Arabia, calculated based on the length of their employment.

UAE Gratuity In the case of gratuity entitlements, they differ depending on the type of contract, whether unlimited or limited..

Saudi Gratuity Like similar to UAE, Saudi Arabia mandates gratuity payments to employees upon the completion of at two years of employment.

Leave Entitlements

Each country has its own specific regulations for annual leave,maternity leave and sick leave law. They must be effectively managed by payroll systems.

annual leave Employees have the right to at least 21 days of annual paid time off in the UAE.

sick leave The two countries Saudi Arabia and the UAE provide sick leave paid with specific limitations dependent on the length of employment.

Maternity Leave Employers are obliged to offer Maternity leaves in each country, generally between 45 and 90 days.

Insuring compliance with Payroll and Benefits regulations

For businesses operating in Saudi Arabia and the UAE and the UAE, compliance with requirements for benefits and payroll is vital to avoid penalties and create a positive work environment.

Best Practices for Compliance

Stay Up-to-date Review and update policies in order to be in sync with changes to GOSI laws in Saudi Arabia and UAE labor laws.

Install Payroll Software Make sure you invest in dependable HR payroll software to handle payroll and benefits as well as compliance easily.

Inform employees Keep employees updated about their rights and benefits as well as ensuring transparency and confidence.

Conclusion

Controlling the payroll process, GOSI compliance and employee benefits, managing employee benefits, GOSI compliance, and payroll Saudi Arabia and the UAE requires a deep knowledge of local regulations as well as effective HR strategies. With the help of complete payroll management tools and staying current in terms of contract rules, businesses can simplify their operations and increase satisfaction of employees. Utilizing technology, like the HR payroll management software provided by OPS helps to be compliant and help the workforce efficiently, which is essential to the long-term success of these ever-changing markets.

OPS offers customized solutions to help companies operating in Saudi Arabia and the UAE adhere to the highest standards of compliance while offering the most efficient tools to manage the benefits of employees and payroll.

[legalfirmindia]

Data Protection: Legal Safeguards for Your Business

In today’s digital age, data is the lifeblood of most businesses. Customer information, financial records, and intellectual property – all this valuable data resides within your systems. However, with this digital wealth comes a significant responsibility: protecting it from unauthorized access, misuse, or loss. Data breaches can have devastating consequences, damaging your reputation, incurring…

[hybridpayroll]

Talent Management in Denver - Hybrid Payroll

What is a talent management system?

A talent management system refers to a suite of software applications and strategies designed to effectively recruit, develop, retain, and manage a company’s workforce. It encompasses various HR functions and processes related to attracting, nurturing, and retaining talent within an organization.

Key components of a talent management system typically include:

Recruitment and Applicant Tracking: Tools for sourcing, attracting, and managing job applicants. This includes job postings, resume screening, and applicant tracking systems.

Performance Management: Systems for setting goals, evaluating performance, providing feedback, and identifying areas for employee development.

Learning and Development: Platforms for training, skill development, and career advancement opportunities, such as online courses, workshops, and personalized learning paths.

Succession Planning: Strategies and tools for identifying and developing future leaders within the organization to fill key roles when needed.

Employee Engagement and Retention: Methods to gauge employee satisfaction, gather feedback, and create strategies to enhance workplace satisfaction and retention.

Analytics and Reporting: Tools that collect and analyze data on various HR metrics to provide insights for better decision-making.

The goal of a talent management system is to align an organization’s workforce with its business goals, ensuring that it attracts and retains top talent while fostering employee growth and development. These systems help streamline HR processes, enhance employee engagement, and contribute to overall organizational success.

Is talent management a HR?

Talent management is closely associated with HR (Human Resources) as it involves strategies and practices related to the acquisition, development, and retention of employees within an organization. In many companies, talent management falls under the umbrella of HR functions.

While HR traditionally focuses on various aspects of employee management, such as hiring, compensation, benefits, and compliance, talent management specifically emphasizes the strategic approach to attracting, nurturing, and retaining top talent. It’s often considered a more proactive and long-term perspective within the broader field of HR.

Talent management extends beyond traditional HR functions by emphasizing the identification of high-potential employees, succession planning, leadership development, and creating an environment that fosters employee growth and engagement.

In summary, while talent management is closely related to HR, it represents a more specialized and strategic aspect of managing human capital within an organization.

[synchronyhr]

Technology Spotlight: Time Management Support

As an HR outsourcing (HRO) organization, SynchronyHR offers clients a one-stop shop for leading payroll, benefits, and HR technology.

https://www.synchronyhr.com/post/technology-spotlight-time-management-support

[policycheckingautomation]

What is business process outsourcing?

Business process outsourcing, or BPO, is the process of hiring a party outside of the firm to execute regular business operations.

An organization can concentrate more of its resources on BPO-enabled operations that give it a competitive edge, superior performance, and better quality. BPO providers are in a good position to accomplish the work with increased accuracy, efficiency, and speed because business processes are their primary focus. BPO Services helps you to focus on your core business development.

[2-2-78-09]

Pathology billing attracts a lot of rejections and denials owing to claim errors. Learn the everything about it to maximize revenue. Outsourcing can assist to increase revenue collections. Call Info today!

[opspayroll]

UAE Employment Contracts: Unlimited vs. Limited and Dubai Labor Laws

When working or hiring in the UAE, understanding the two main types of employment contracts—unlimited and limited—is crucial. Each contract type has its unique terms and conditions that affect everything from job security to termination rights. This blog will break down the differences, highlight the key aspects of Dubai labor contracts, and guide you on choosing the right contract type for your business or career in the UAE.

What is an Unlimited Contract in the UAE?

An unlimited contract in the UAE is an open-ended employment agreement. It does not specify a fixed duration of employment and provides flexibility for both the employer and employee. These contracts are popular for roles that are ongoing, where no clear end date is required.

Key features of an unlimited contract include:

No set end date.

Either party can terminate the contract, provided appropriate notice is given.

Commonly used for long-term employment relationships.

Termination of an Unlimited ContractIn an unlimited contract, either party can terminate the employment by providing notice, usually between 30 and 90 days. Employees under this type of contract are entitled to severance pay based on their length of service.

Tip: Unlimited contracts offer greater job security, making them attractive for employees seeking long-term stability.

What is a Limited Contract in the UAE?

A limited contract in the UAE is a fixed-term agreement where both the start and end dates of the employment are clearly stated. Typically lasting for two to three years, this contract type is ideal for specific project-based roles or positions with a clear end date.

Key features of a limited contract include:

Defined start and end dates.

Automatic expiration unless renewed.

Termination before the end of the contract term may result in penalties for either party.

Termination of a Limited ContractIf a limited contract is terminated before the agreed-upon end date, the party responsible for the termination may be required to compensate the other party. This compensation usually equals the salary for the remainder of the contract period or up to three months' salary.

Tip: Limited contracts are often used for projects or seasonal jobs and offer clearer terms of service duration.

Dubai Labor Contract: Key Insights

If you're working in or hiring for a position based in Dubai, it’s important to note that Dubai labor contracts adhere to the UAE's labor laws but may include specific guidelines due to the local legal framework. Whether you're dealing with a Dubai labor contract under a free zone or on the mainland, here are key points to consider:

Legal Framework: Dubai follows federal labor law but has specific rules under free zones such as DIFC and JAFZA.

Salary and Wages: Employers must comply with minimum wage laws and ensure timely salary payments.

Employee Rights: Dubai labor contracts must respect employee rights, including timely payments, end-of-service gratuity, and appropriate leave.

Note: Employers in Dubai should familiarize themselves with local regulations and ensure their employment contracts comply with both UAE labor laws and specific Dubai requirements.

Key Considerations for Employers and Employees

When deciding between an unlimited contract and a limited contract in the UAE, both employers and employees should consider the following:

Nature of the Job: Is the job project-based or long-term? For short-term projects, a limited contract is more appropriate, while for ongoing roles, an unlimited contract is often preferred.

Employee Rights: Understand the severance pay and end-of-service gratuity rules for each contract type. Unlimited contracts may offer more flexible severance pay, while limited contracts involve strict penalties for premature termination.

Job Security: Employees seeking long-term stability may prefer unlimited contracts. However, limited contracts offer clearly defined periods of employment, ideal for project-based roles.

Legal Obligations: Both contract types are governed by UAE labor laws, and it's crucial to adhere to these legal obligations to avoid disputes or penalties.

Benefits of Each Contract Type

Both unlimited contracts and limited contracts offer distinct advantages, depending on the employer's business needs and the employee's career goals.

Advantages of Unlimited Contracts:

Greater job security for employees.

Flexibility in termination, provided notice is given.

Well-suited for long-term roles and stable employment.

Advantages of Limited Contracts:

Clear terms of employment with defined start and end dates.

Ideal for project-based or seasonal roles.

Provides a structured employment relationship.

Summary: Choosing the right contract type involves balancing job security, flexibility, and the nature of the work. Employers and employees should assess their individual needs before committing to a contract type.

Final Thoughts on UAE Employment Contracts

The UAE offers a well-regulated employment system with both unlimited and limited contracts to meet diverse business needs. Employers must ensure compliance with UAE labor laws and select the contract type that aligns with their business requirements. Employees, on the other hand, should carefully review their contract terms to protect their rights and job security.

Whether you're hiring in Dubai or working in the UAE, understanding the nuances of unlimited and limited contracts is crucial for making informed decisions. By choosing the right contract type, you can establish a productive and legally sound employment relationship.

For expert advice and assistance with your UAE employment contracts, OPS is here to help. As a trusted partner, OPS ensures that your business is compliant with UAE labor laws while providing tailored solutions for your employment needs. Contact OPS today for reliable support in navigating your labor contracts and ensuring your company’s success!

[mostlysignssomeportents]

Cigna’s nopeinator

I'm touring my new, nationally bestselling novel The Bezzle! Catch me THURSDAY (May 2) in WINNIPEG, then Calgary (May 3), Vancouver (May 4), Tartu, Estonia, and beyond!

Cigna – like all private health insurers – has two contradictory imperatives:

To keep its customers healthy; and

To make as much money for its shareholders as is possible.

Now, there's a hypothetical way to resolve these contradictions, a story much beloved by advocates of America's wasteful, cruel, inefficient private health industry: "If health is a "market," then a health insurer that fails to keep its customers healthy will lose those customers and thus make less for its shareholders." In this thought-experiment, Cigna will "find an equilibrium" between spending money to keep its customers healthy, thus retaining their business, and also "seeking efficiencies" to create a standard of care that's cost-effective.

But health care isn't a market. Most of us get our health-care through our employers, who offer small handful of options that nevertheless manage to be so complex in their particulars that they're impossible to directly compare, and somehow all end up not covering the things we need them for. Oh, and you can only change insurers once or twice per year, and doing so incurs savage switching costs, like losing access to your family doctor and specialists providers.

Cigna – like other health insurers – is "too big to care." It doesn't have to worry about losing your business, so it grows progressively less interested in even pretending to keep you healthy.

The most important way for an insurer to protect its profits at the expense of your health is to deny care that your doctor believes you need. Cigna has transformed itself into a care-denying assembly line.

Dr Debby Day is a Cigna whistleblower. Dr Day was a Cigna medical director, charged with reviewing denied cases, a job she held for 20 years. In 2022, she was forced out by Cigna. Writing for Propublica and The Capitol Forum, Patrick Rucker and David Armstrong tell her story, revealing the true "equilibrium" that Cigna has found:

https://www.propublica.org/article/cigna-medical-director-doctor-patient-preapproval-denials-insurance

Dr Day took her job seriously. Early in her career, she discovered a pattern of claims from doctors for an expensive therapy called intravenous immunoglobulin in cases where this made no medical sense. Dr Day reviewed the scientific literature on IVIG and developed a Cigna-wide policy for its use that saved the company millions of dollars.

This is how it's supposed to work: insurers (whether private or public) should permit all the medically necessary interventions and deny interventions that aren't supported by evidence, and they should determine the difference through internal reviewers who are treated as independent experts.

But as the competitive landscape for US healthcare dwindled – and as Cigna bought out more parts of its supply chain and merged with more of its major rivals – the company became uniquely focused on denying claims, irrespective of their medical merit.

In Dr Day's story, the turning point came when Cinga outsourced pre-approvals to registered nurses in the Philippines. Legally, a nurse can approve a claim, but only an MD can deny a claim. So Dr Day and her colleagues would have to sign off when a nurse deemed a procedure, therapy or drug to be medically unnecessary.

This is a complex determination to make, even under ideal circumstances, but Cigna's Filipino outsource partners were far from ideal. Dr Day found that nurses were "sloppy" – they'd confuse a mother with her newborn baby and deny care on that grounds, or confuse an injured hip with an injured neck and deny permission for an ultrasound. Dr Day reviewed a claim for a test that was denied because STI tests weren't "medically necessary" – but the patient's doctor had applied for a test to diagnose a toenail fungus, not an STI.

Even if the nurses' evaluations had been careful, Dr Day wanted to conduct her own, thorough investigation before overriding another doctor's judgment about the care that doctor's patient warranted. When a nurse recommended denying care "for a cancer patient or a sick baby," Dr Day would research medical guidelines, read studies and review the patient's record before signing off on the recommendation.

This was how the claims denial process is said to work, but it's not how it was supposed to work. Dr Day was markedly slower than her peers, who would "click and close" claims by pasting the nurses' own rationale for denying the claim into the relevant form, acting as a rubber-stamp rather than a skilled reviewer.

Dr Day knew she was slower than her peers. Cigna made sure of that, producing a "productivity dashboard" that scored doctors based on "handle time," which Cigna describes as the average time its doctors spend on different kinds of claims. But Dr Day and other Cigna sources say that this was a maximum, not an average – a way of disciplining doctors.

These were not long times. If a doctor asked Cigna not to discharge their patient from hospital care and a nurse denied that claim, the doctor reviewing that claim was supposed to spend not more than 4.5 minutes on their review. Other timelines were even more aggressive: many denials of prescription drugs were meant to be resolved in fewer than two minutes.

Cigna told Propublica and The Capitol Forum that its productivity scores weren't based on a simple calculation about whether its MD reviewers were hitting these brutal processing time targets, describing the scores as a proprietary mix of factors that reflected a nuanced view of care. But when Propublica and The Capitol Forum created a crude algorithm to generate scores by comparing a doctor's performance relative to the company's targets, they found the results fit very neatly into the actual scores that Cigna assigned to its docs:

The newsrooms’ formula accurately reproduced the scores of 87% of the Cigna doctors listed; the scores of all but one of the rest fell within 1 to 2 percentage points of the number generated by this formula. When asked about this formula, Cigna said it may be inaccurate but didn’t elaborate.

As Dr Day slipped lower on the productivity chart, her bosses pressured her bring her score up (Day recorded her phone calls and saved her emails, and the reporters verified them). Among other things, Dr Day's boss made it clear that her annual bonus and stock options were contingent on her making quota.

Cigna denies all of this. They smeared Dr Day as a "disgruntled former employee" (as though that has any bearing on the truthfulness of her account), and declined to explain the discrepancies between Dr Day's accusations and Cigna's bland denials.

This isn't new for Cigna. Last year, Propublica and Capitol Forum revealed the existence of an algorithmic claims denial system that allowed its doctors to bulk-deny claims in as little as 1.2 seconds:

https://www.propublica.org/article/cigna-pxdx-medical-health-insurance-rejection-claims

Cigna insisted that this was a mischaracterization, saying the system existed to speed up the approval of claims, despite the first-hand accounts of Cigna's own doctors and the doctors whose care recommendations were blocked by the system. One Cigna doctor used this system to "review" and deny 60,000 claims in one month.

Beyond serving as an indictment of the US for-profit health industry, and of Cigna's business practices, this is also a cautionary tale about the idea that critical AI applications can be resolved with "humans in the loop."

AI pitchmen claim that even unreliable AI can be fixed by adding a "human in the loop" that reviews the AI's judgments:

https://pluralistic.net/2024/04/23/maximal-plausibility/#reverse-centaurs

In this world, the AI is an assistant to the human. For example, a radiologist might have an AI double-check their assessments of chest X-rays, and revisit those X-rays where the AI's assessment didn't match their own. This robot-assisted-human configuration is called a "centaur."

In reality, "human in the loop" is almost always a reverse-centaur. If the hospital buys an AI, fires half its radiologists and orders the remainder to review the AI's superhuman assessments of chest X-rays, that's not an AI assisted radiologist, that's a radiologist-assisted AI. Accuracy goes down, but so do costs. That's the bet that AI investors are making.

Many AI applications turn out not to even be "AI" – they're just low-waged workers in an overseas call-center pretending to be an algorithm (some Indian techies joke that AI stands for "absent Indians"). That was the case with Amazon's Grab and Go stores where, supposedly, AI-enabled cameras counted up all the things you put in your shopping basket and automatically billed you for them. In reality, the cameras were connected to Indian call-centers where low-waged workers made those assessments:

https://pluralistic.net/2024/01/29/pay-no-attention/#to-the-little-man-behind-the-curtain

This Potemkin AI represents an intermediate step between outsourcing and AI. Over the past three decades, the growth of cheap telecommunications and logistics systems let corporations outsource customer service to low-waged offshore workers. The corporations used the excuse that these subcontractors were far from the firm and its customers to deny them any agency, giving them rigid scripts and procedures to follow.

This was a very usefully dysfunctional system. As a customer with a complaint, you would call the customer service line, wait for a long time on hold, spend an interminable time working through a proscribed claims-handling process with a rep who was prohibited from diverging from that process. That process nearly always ended with you being told that nothing could be done.

At that point, a large number of customers would have given up on getting a refund, exchange or credit. The money paid out to the few customers who were stubborn or angry enough to karen their way to a supervisor and get something out of the company amounted to pennies, relative to the sums the company reaped by ripping off the rest.

The Amazon Grab and Go workers were humans in robot suits, but these customer service reps were robots in human suits. The software told them what to say, and they said it, and all they were allowed to say was what appeared on their screens. They were reverse centaurs, serving as the human faces of the intransigent robots programmed by monopolists that were too big to care.

AI is the final stage of this progression: robots without the human suits. The AI turns its "human in the loop" into a "moral crumple zone," which Madeleine Clare Elish describes as "a component that bears the brunt of the moral and legal responsibilities when the overall system malfunctions":

https://estsjournal.org/index.php/ests/article/view/260

The Filipino nurses in the Cigna system are an avoidable expense. As Cigna's own dabbling in algorithmic claim-denial shows, they can be jettisoned in favor of a system that uses productivity dashboards and other bossware to push doctors to robosign hundreds or thousands of denials per day, on the pretense that these denials were "reviewed" by a licensed physician.

If you'd like an essay-formatted version of this post to read or share, here's a link to it on pluralistic.net, my surveillance-free, ad-free, tracker-free blog:

https://pluralistic.net/2024/04/29/what-part-of-no/#dont-you-understand

[galaxygolfergirl]

Watcher's Expenses

I didn't major in accounting: I took three classes and it grinded my brain to a fine powder. However, after graduating with a business admin degree, being a former eager fan of their videos, and from a cursory glance over their socials, there's a lot to consider in their spending behavior that really could start racking up costs. Some of these things we've already noticed, but there are other things I'd like to highlight, and I'll try to break it down into the different categories of accounting expenses (if I get something wrong, let me know. I was more concentrated in marketing 🤷‍♀️). I'm not going to hypothesize numbers either, as that would take out more time than I'm willing to afford-- you can assume how much everything costs. Anyways, here's my attempt at being a layman forensic accountant:

Note: All of this is assuming they're operating above board and not engaging in any illegal practices such as money laundering, tax evasion, not paying rent, etc.

Operating Expenses

Payroll: 25+ staff salaries and insurance

Overhead Expenses

CEO/founder salaries

Office space leasing or rent (In L.A, one of the most expensive cities in the US)

Utilities (water, electricity, heating, sanitation, etc.)

Insurance

Advertising Costs

Telephone & Internet service

Cloud Storage or mainframe

Office equipment (furniture, computers, printers, etc.)

Office supplies (paper, pens, printer ink, etc.)

Marketing costs (Social media marketing on Instagram, Youtube, SEO for search engines, Twitter, etc. Designing merchandise and posters, art, etc. )

Human Resources (not sure how equipped they are)

Accounting fees

Property taxes

Legal fees

Licensing fees

Website maintenance (For Watchertv.com, Watcherstuff.com, & Watcherentertainment.com)

Expenses regarding merchandising (whoever they contract or outsource for that)

Inventory costs

Potentially maintenance of company vehicles

Subsequent gas mileage for road trips

Depreciation (pertains to tangible assets like buildings and equipment)

Amortization (intangible assets such as patents and trademarks)

Overhead Travel and Entertainment Costs (I think one of the biggest culprits, evident in their videos and posts)

The travel expenses (flights, train trips, rental cars, etc. For main team and scouts)

Hotel expenses for 7-8 people at least, or potentially more

Breakfasts, lunches and dinners with the crew (whether that's fully on their dime or not, I don't know; Ryan stated they like to cover that for the most part)

Recreational activities (vacation destinations, amusement parks, sporting activities etc.)

The location fees

Extraneous Overhead costs (not sure exactly where these fall under, but another culprit, evident in videos and posts)

Paying for guest appearances

Expensive filming & recording equipment (Cameras, sound equipment, editing software subscriptions, etc.)

The overelaborate sets for Ghost files, Mystery Files, Puppet History, Podcasts etc. (Set dressing: Vintage memorabilia, antiquated tech, vintage furniture, props, etc.)

Kitchen & Cooking supplies/equipment

Office food supply; expensive food and drink purchases for videos

Novelty items or miscellaneous purchases (ex. Ghost hunting equipment, outfits, toys, etc.)

Non-Operating Expenses

These are those expenses that cannot be linked back to operating revenue. One of the most common examples of non-operating expenses is interest expense. This is because while interest is the cost of borrowing money from a creditor or a bank, they are not generating any operating income. This makes interest payments a part of non-operating expenses.

Financial Expenses

Potential loan payments, borrowing from creditors or lenders, bank loans, etc.

Variable Expenses

Hiring a large amount of freelancers, overtime expenditure, commissions, etc.

PR consultations (Not sure if they had this before the scandal)

Extraordinary Expenses

Expenses incurred outside your company’s regular business activities and during a large one-time event or transactions. For example, selling land, disposal of a significant asset, laying off of your employees, unexpected machine repairing or replacement, etc.

Accrued Expenses

When your business has incurred an expense but not yet paid for it.

------------------------------------------------------------------------------------------------------------------------

(If there's anything else I'm missing, please feel free to add or correct things)

To a novice or a young entrepreneur, this can be very intimidating if you don't have the education or the support to manage it properly. I know it intimidates the hell out of me and I'm still having to fill in the gaps (again, if I've mislabeled or gotten anything wrong here, please let me know). For the artistic or creative entrepreneur, it can be even harder to reconcile the extent of your creative passions with your ability to operate and scale your business at a sustainable rate. That can lead to irresponsible, selfish, and impulsive decisions that could irreparably harm your brand, which is a whole other beast of its own.

My guess at this point is that their overhead and operation expenses are woefully mismanaged; they've made way too many extraneous purchases, and that they had too much confidence in their audience of formerly 2.93 million to make up for the expenses they failed to cover.

It almost seems as if their internal logic was, "If we make more money, we can keep living the expensive lifestyle that we want and make whatever we want without anyone telling us we can't, and we want to do it NOW, sooner rather than later because we don't want wait and compromise our vision." But as you can see, the reality of fulfilling those ambitions is already compromised by the responsibility of running a business.

And I wrote this in another post here, but I'll state it again: Running a business means you need to be educated on how a business can successfully and efficiently operate. Accounting, marketing, social media marketing, public relations, production, etc; these resources and internet of things is available and at your disposal. If they had invested more time in educating themselves on those aspects and not made this decision based on artistic passion (and/or greed), they would have not gotten the response they got.

Being a graphic designer, I know the creative/passionate side of things but I also got a degree/got educated in business because I wanted to understand how to start a company and run it successfully. If they’re having trouble handling the responsibility of doing that, managing production costs, managing overhead expenses, and especially with compensating their 25+ employees, then they should hire professionals that are sympathetic to their creative interests, but have the education and experience to reign in bad decisions like these.

Anyways, thanks for coming to my TedTalk. What a shitshow this has been.

[lastoneout]

Y'all I am so fucking tired of the like, privatization of healthcare and also the way medicaid works. I've been trying to get this blood work done that I need before my surgery next month and there are apparently only two types of clinics I can go to, SonoraQuest, which has reasonable hours and is open on Saturdays, or LabCorp which is only open on weekdays and closes at 3pm.

Turns out I actually can't go to SonoraQuest because they don't take Medicaid, something I found out after going there and sitting in the lobby for an hour. I have to go to LabCorp.

The problem with LabCorp is that my fiancé works until 3:30pm and he's having a very busy week and thus hasn't been able to leave early to take me. I can't take public transit because I'm disabled and don't have a wheelchair yet and going on foot or with my rollator would ruin my ability to do anything for the rest of the day and possibly the next couple of days too. I can't take a lyft or Uber because my fiancé is the sole breadwinner for our household(I can't work) and right now his shit idiot credit union is straight up breaking the law and repeatedly flagging his cards for *possible* fraud despite there being no fraud, and he's gone through like 5 debit cards in the last two months over this(he's gone in to complain about all the ways this is fucking him over big time and they told him there's literally nothing they can do). He's moving his money to a new credit union atm but that takes time, so he legit cannot access his money and thus he can't give me any to pay for the ride. (The bus also costs money I don't have so that's another reason I can't take it.)

I decided this is all horseshit and called the hospital my surgery will be at and asked if there is somewhere else I can go because this isn't working, and the lady told me I can just go to the hospital for it and that they're open until 7pm. So I went there yesterday, only to find out that the people who do the blood work at the hospital is fucking SonoraQuest and they close at 4pm.

LabCorp does have a service where they'll send a mobile team to your house to collect the blood, but it costs $35 which again. We cannot access my fiancé's money atm. Also that's more than a lyft would cost so even if I had access to money I would prefer to go there myself.

So I am hoping my fiancé will be able to get off work early today so we can go down to LabCorp when they're open and hopefully they won't tell me I need an appointment or that coming in like an hour before they close isn't allowed.

Anyway call me a boomer but there is no fucking world in which I shouldn't be able to just go to my fucking neurosurgeon's office and have a nurse take my blood. Like I should just be able to do that. Or just walk into the hospital which overall does take my insurance and have one of the like 100s of nurses take my goddamn blood. This used to be how this shit worked. Why the fuck have we outsourced this to for profit clinics that suck ass, forcing me to try to move heaven and earth to get myself to a clinic with insanely unreasonable hours, stressing me the fuck out. Also why does having Medicaid mean I have to go to the worse clinic like this always happens, the clinics that take Medicaid are always garbage compared to the ones that don't it's such crap that the poor folks have to put up with sub-par medical services just bcs we're poor.

Anyway I'm going to go scream into a pillow for a while and hope to god I'm able to get this out of the way today bcs if not I'm probably just gonna have to call the neurosurgeon and let them know I might not be able to do the blood work because unfortunately it's fucking impossible.

[synchronyhr]

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[pinkbolts]

> @jewelstole   …  like thee starter.

usual  nights  that  were  spent  prowling  the  city  for  crime  or  gossiping  with  the  likes  of  fond  family,   were  all  but  forgotten  this  evening.     swapping  purple  body—suit  for  a  form  fitting  scarlet  gown   (   courtesy  of  a  lot  of  sowing  &  elbow  grease   )   ———   tamaranean  dressed  to  near  show—stopping  perfection,  in  a  ball—room  she  had  no  business  conversing  in;   playing  the  perfect  hostess  it  seemed,   champagne  in  hand.   starfire…     auctioning  off  jewels  from  her  star  system  in  hopes  of  raising  money  for..   an  abundance  of  things.   the  tower  could  only  run  so  far  without  the  help  of  nightwing’s  generational  wealth,  raven’s  magic,  cyborg’s  solar  panels  &  energy  conservation,  terra’s  garden  &  beast  boy’s…   what—have—you.   someone  had  to  outsource  &  she  decided  that  someone  would  be  her.   hosting  galas  &  fundraisers  for  better  causes;   victims  of  world—ending  events  &  their  families,   as  well  as  funding  task-forces   &   vigilante  groups  like  her  own.   it  was  a  good  thought,   better  in  theory  considering  insurance  companies  would  rather  see  people  rot   &   police  officers  hoped  people  like  her  would  do  the  same   …   might’ve  been  the  reason  security  here  was  so  low.   that  &  star  would  much  rather  handle  any   &   every  threat  by  herself.   and  speaking  of  threats…   green  gaze  might’ve  caught  one  before  the  night  even  began.

selina  kyle,   an  eye  she’d  never  thought  she’d  catch  past  10PM.   then  realization  clicks.   gaze  shifts  from  jewel  to  jewel  thief’s  admiring  gaze.   that  is  never  good,   is  it?   there’s  an  usher  past  a  guest  &  auctionee  or  two  before  star  &  kitten  at  standing  side—by—side,     “   i  was  told  that  it is  never  a  good  thing  if  i  see  you  looming  around  priceless  relics.   “   spoken  directly  to  the  much  shorter  woman:   it  was  bold,   considering  no  one  really  had  the  guts  to  approach  the  kitty  when  she  was  ‘working’  but   …    star  didn’t  heed  warnings  all  too  well.   narrowed  eyes  watch  her  move,   ghost  movements  around  a  glass  case.

she’d  be  the  first  to  break  focus,    “   i  do not  like  to  pass—judgment  where  it  is  not  due…   it  is  unbecoming  &  reckless.   so  please  correct  me  if  i am  wrong.   “   glass  of  bubbly  placed  on  a  server’s  tray  before  attention  turned  right  back  to  the  cat.   attempts  were  made  to  strip  herself  of  accusatory  tone  but,   to  no  avail  she  continues,    “   are  you  here  to  take  something  from  the  collection?   “ koriand'r would take whatever answer the cat was bound to give her.