The Voice June 1999
Vol. 35 No. 3Spring has sprung, and the baseball season is upon us. I don 't know about each of you but my winter seemed to be a short one; as we didn't get below freezing until after Christmas, and we were making maple syrup by the middle of March, which in the past years for us was closer to the first of April.
I am putting out a personal request, that if any one is interested in being part of our board of directors please let anyone of us know. We currently have three openings on the board of directors, of which we only have two interested people. We really need a third person to help us out. Your commitment is to join us each Thursday prior to our regular quarterly meeting to give us input on the future of our organization. If you have other questions regarding what you would need to do please feel free to give me a call.
I know that this is a busy year for a lot of us with Y2K issues, new software installations, and Medicare Secondary Payer audits. So as your President I am reminding each one of you to take some time for yourself this summer and enjoy. Remember when your life here on earth is all done and they type those words on your tombstone, don 't have it say "he/she spent a lot of time in the office", have it read more like "he/she enjoyed life or was a great father or mother".
See you at the Landmark in Door County, August 18 - 20th, for our Annual Institute
Steve Marg
President WMCA
Prompt Payment for Healthcare Claims
By: Tim Hartin, WHA General Counsel
Brian Potter, WHA Director, Health Care Information
I. Introduction
Wisconsin's prompt payment law is discussed in more detail in General Memo 19-99, dated February 19, 1999. Briefly, the prompt payment statute provides that "insurers shall promptly pay every insurance claim," that " a claim shall be over due if not paid within thirty days after the insurer is furnished written notice of the fact of a covered loss and of the amount of the loss" and that "all over due payments shall bear simple interest at the rate of 12% per year." ' The statute makes clear that it applies to claims for health care services.2
However, that statute also provides that "the payment of a claim shall not be overdue until 30 days after the insurer receives proof of loss required under the policy or the equivalent evidence of such loss.~3 In other words, a claim is not overdue until it is a "clean claim." In operation, this languagemeansthatthe30-dayclockdoesnotbegintorun until the insurer starts it by admitting that it has a "clean claim."
II. Office of the Commissioner of Insurance
Data collected through the WHA Industry Monitoring System (IMS) indicates that it is taking longer for providers to receive payments from insurers. WHA has had conversations with the Wisconsin Office of the Commissioner of Insurance (OCI) making it aware of these troubling trends. OCI seemed willing to pursue cases that violate the prompt payment statute. To help address the problem, though, the OCI needs the cooperation of hospitals and health systems.
Of course, the first efforts to resolve payment issues should be between the provider and the payer. If, after exhausting all negotiation possibilities, the payment issues can't be resolved, contacting OCI can be a next step. Hospitals and health systems that would like the OCI to investigate possible violations of the prompt payment law need to file a complaint with OCI. A complaint form can be found on the OCI website at: http://badger.state.wi.us/agencies/oci/com_form.htm. If you don't have Internet access or if you have a question regarding a complaint, the OCI has information and complaint staff available to help you. They can be reached at 800/236-8517.
III. Contracting and "Self-Help"
Regardless of whether they wish to involve OCI in the payment issue, all WHA members should consider taking steps to make the prompt payment statute more real and enforceable.
• Providers should decline any invitations to waive their rights under the prompt payment statute. If these rights have already been waived, providers should at least attempt to rescind the waiver.
• In particular, the various schemes that involve "loans" to the provider by the payer should be rejected. These loan arrangements typically involve a "loan" that requires the provider to accrue interest on amounts that are due and owing to the provider, with the understanding that the interest owned by the provider under the loan and the interest owned by the payer under the prompt payment statute will offset and no one will actually pay any interest.
• Providers should seek payer agreement to clear definitions of "the proof of loss required under the policy or the equivalent evidence of such loss" that is needed to establish a clean claim. For example, submission of the payer's properly completed billing forms should be deemed to bea clean claim unless, within a specified period of time. the payer gives written notice to the contrary that specifies exactly what is needed to complete the claim.
• In the absence of a more cooperative approach from payers, providers should consider taking a more aggressive approach by determining which claims are reasonably considered to be clean claims, calculating interest on such claims pursuant to the prompt payment act, and billing the payer for the interest.
IV. Conclusion and Recommendations
The Wisconsin Prompt payment statute suffers from the flaws common to all such statutes. However, it does provide a tool that can be useful in encouraging payers to shorten their payment cycle. As always when making major business decisions involving legal issues, hospitals and health systems are encouraged to consult with their attorneys.
1§ 628.46(1), Wis. Stats.
2§ 628.46(3), Wis. Stats.
3§ 628.46(2), Wis. Stats.
state of Wisconsin
Share your experiences! A wedding? A significant anniversary or Birthday?
A job change? An unusual vacation? A new baby? An unusual experience? A promotion? Commentary!
Are any of these events going on in your life or of anyone we know?Old Faces - New Places
Citing the demands of travel, Mike Bednarz is gone from Zimmerman & Associates. Mike has joined the receivables management firm of Robinson & Brebner as Vice President of Sales. R&B specializes in Medicaid eligibility. Mike joined Zimmerman & Associates three years ago from St. Francis Hospital in Milwaukee.Al Gomez, formerly with the Medical College of Wisconsin, is the new Patient Accounts Director at All Saints in Racine.
Vacation News
Waukesha Memorial's Leigh Ann Collins and husband Pat recently traveled to Ireland.Former WMCA Board Member Linda Krish and daughter Rachael enjoyed a vacation in Hawaii. Linda is Director of Patient Services at Holy Family Memorial Medical Center in Manitowoc.
Trivia
According to the Metropolitan Milwaukee Association of Commerce, over 1.5 million individuals reported incomes over $200,000. Of those, 1,044 using deductions, credits, and adjustments paid no income taxes. (Wonder who pays their share?)
Intertainment
Take some time out from stress and ponder the following found on the Internet:
• I just got lost in thought. It was unfamiliar territory.
• 99% of lawyers give the rest a bad name.
• Despite the cost of living, have you noticed how popular it remains?
• He who laughs last thinks slowest.
• Eagles may soar, but weasels don't get sucked into jet engines.
• I drive way too fast to worry about cholesterol.
• If at first you don't succeed, destroy all evidence that you tried.
• For every action there is an equal and opposite criticism.
• Bills travel through the mail at twice the speed of checks.
• The sooner you fall behind, the more time you'll have to catch up.Etc.
12 Things to Remember:• The value of time
• The success of perseverance.
• Do not be discouraged, no matter what the problems seem to be.
• Get great pleasure out of your work.
• The dignity of simplicity.
• The worth of character
• The power of kindness.
• You must set the standard
• The obligation, duty, and wisdom of economy
• The virtue of patience
• The improvement to talent.
• The sincerity of real joy originating something.
Get Candidates To Open Up
When you interview job candidates, try these six questions to get information they probably wouldn't otherwise volunteer:
• "What did you like best about your last job?" If the answer isn't in-depth, they may not be very interested or knowledgeable - and may not want a challenge.
• "How would you have improved your last job?" This will test the candidate's originality and creativity.
• "Describe the best person who worked for, or with, you."This will reveal how well they get along with others.
• "Describe crises in the past that made your schedule your time." If they say they worked extra hours, they're committed to doing a good job. • "Why are you leaving your job?" If they bad-mouth their current employer, imagine what they'll say about you.
•"How would you like our company to help you join us?" Watch out for the two extremes - if they want a lot of help or none.Source: Robert Half, cited in The Book of Business Knowledge, Boardroom, 330 W. 42nd St., 14th Floor, New York, NY 10036.
Wisconsin Medical Credit Association, Inc. Purposes and Objectives
To promote good will and better understanding between medical managers and associates;
To stimulate interest in educational activities for its members;
To hold regularly scheduled meetings (clinics, workshops and seminars) where members may receive instruction and exchange views and experiences;
To collect, correlate and disseminate materials and information to assist its members to better understand and apply principles of good medical credit procedures;
To keep current on passage and modifications of laws needed for the equal and just protection of patients, hospitals, clinics and doctor's offices;
To coordinate and improve methods of medical credit procedures, patient and insurance collection.
DEDICATED TO THE IMPROVEMENT AND EFFICIENCY OF MEDICAL CREDIT MANAGEMENT
Take This Spelling Challenge
Pick the correct word in each set of parentheses to see if you're equal to this spelling challenge:
1. We'll fall behind our competitors if we don't soon (seize/ sieze) this opportunity.
2. I'd say that (supercede/superceed/supersede) is a tricky word that even good spellers sometimes have trouble with.
3. If you had answered your e-mail messages when you should have, this would not have (occurred/occured/ ocurred).
4. After two weeks, it was obvious that he didn't have the (temperment/temperament/temprament) to succeed as a customer service representative. 5. Rather than (embarass/embarras/embarrass) Claude, I didn't reveal who had goofed on the Luden account.
6. The boss said we should view working a flexible schedule as a (privlidge/privilege/priviledge), not a right.
7. After she (acknowledged/acknowleged) our presence, she seemed more friendly.Answers: 1. Seize 2. supersede. 3. occurred. 4 temperament 5. embarrass 6. privilege 7. acknowledged.
Five Traits of Good Leaders
Increase your effectiveness as a team leader with these suggestions from Barry J. Farber, president of Farber Training Systems Inc.:
• Don't push too much. Encourage your team members to do more, but know when it's too much. The signs: flaring tempers, moodiness, sarcasm.
• Exhibit good values. As a leader, your example will be followed - whether or not you're trustworthy and committed.
• Roll up your sleeves. Never be afraid to do what it takes to get the job done. Team members will respect you more when you show willingness to work alongside them.
• Serve others. " How can I help you? " Is a good phrase for co workers as well as for customers. And by helping your team succeed, you'll succeed as well.
Source: Leadership for the Front Lines, 24 Rope Ferry Road, Waterford, CT 06386.
How To Handle Office Oafs
File these firm responses to use when an office oaf's insensitive comments or actions dumbfound or anger you:
• The oaf tells a tasteless joke.
Responses:" I wonder why you chose to tell me that joke right now. "You also can stare blankly at the oaf. Or you can show no reaction and walk away.• While introducing a group in your office to a visitor, the oaf bypasses you.
Responses: Act like a leader and say "Now that you all know each other, I can introduce myself. I'm..." Or just introduce yourself with a warm smile and an extended hand.•In a sarcastic or superior tone, the oaf says something such as, I’m amazed that you even know how to do that."
Responses: Ask "What did you especially like about what I did?" Or say "Thank you. When I carne here, they were hiring only the best."Source: Beth Fowler, P.O. Box 284, Hanover, PA 17331.
How Much is a Patient Account Manager Worth
The health care parallel
Over the past 20 years, the health care industry has vastly underestimated the true value of a dedicated and highly skilled patient accounts staff. Patient accounts managers, billers, coders and collectors need great skill to manage the accounts receivable (A/R) and maintain compliance with payers. Still, patient accounts staff turnover is high, due partially to minimal return for maximum effort. A survey released earlier this year revealed that an alarming number of CFOs had very little confidence in their patient accounts managers and the department as a whole. This could be because many CFOs don't realize the value and qualifications of the individuals in the department and what they bring to the organization. Like the executor's attitude toward the contents of the attic, sometimes upper management prefers not to be bothered with the patient accounting department, and would rather outsource it.A vital element
Lower level managers and PAMs themselves know better. If the patient accounting staff fails, the whole facility is affected. And with a continued focus on cutting costs, health care organizations are in greater financial distress than ever. How can a patient accounting department continue to support a facility when budget and staff are reduced again and again?This was never more apparent than in the recent case of a small health care provider trying to cut costs. The decision was made to cut 15 percent of the budget from all departments. At the time, the patient accounting department was made up of six staff members and the patient accounts manager. To meet the requirement, the PAM had to fire one employee and reduce the hours of another, though average tenure of these employees was in excess of twelve years and they had both maintained good cash flow. The staff member who was forced to reduce her hours immediately transferred to a full time position in another department within the health system. The sudden workload increase took its toll on morale. Two of the remaining four staffers sought employment elsewhere rather than take on additional work with no increase in pay.
With staff cut by two-thirds, the manager could no longer focus on A/R management. Instead, he had to try to assemble a qualified staff as quickly as possible. He was quickly overwhelmed as days in A/R went up and cash flow dropped. Patient complaints began to pour in and staff morale continued to decline.
Unable to find qualified applicants, the PAM hired my outsourcing firm to help. At first, bids for the cost of assistance were determined unacceptable by the CFO, but once cash flow problems became critical, the CFO could no longer wait.
My firm quickly provided six staff members to help get the A/R back under control, but the problems continued. The two original billers came to realize that the staff we provided was being paid more to do the job they had been doing for 12 to 15 years. As a result of this insult, they left as well. Once again, we were asked to provide additional staff.
Result:: It has now been 16 months since the firm took over. And, though the facility reduced the budget again, the patient accounting budget was left untouched. It's sad that it takes a crisis of this scale for patient accounting staff to be taken seriously, not treated as expendable drones.
The lack of value placed on the patient accounting department has caused the pool of qualified PAMs to dissipate over the last decade. Those health care providers who now realize the value of talented PAMs are now forced to compete for them or lure them from competitors.
Taking action
While most providers continue to invest less in their patient accounting departments, a few are taking a proactive approach. Some providers are currently reinvesting in the department by providing the staff with technology and incentives to promote efficiency and improve results. Some of the more aggressive providers are investigating a joint venture option with an outsourcing partner. By partnering with an outsourcing firm, the health system can manage business office functions as an entirely separate entity.unaffected by corporate decisions such as staff and budget reductions. Mergers and acquisitions have also added to the problems plaguing patient ac counting departments. Many employees would rather leave than deal with the uncertainty of per haps not having a job in a month or a week. Budgets continue to shrink, and PAMs are expected to invent ways to maintain results while cut ting costs.
It can take a year or longer to properly train a good biller. But today's health care environment doesn't foster such a commitment to long-term training and education. Instead, after a few weeks of training, billers are left to fend for themselves, learning as they go. This is actually more ex pensive than extended training, because each billing mistake has its own price tag.
In the example above, cost cutting was an attempt to find a short-term solution for a long-term problem. In reality, the hospital had qualified staff in place at a bargain price, yet because the health system had so little knowledge of these employees and their value, they eventually paid two and a half times what they had been paying for the same result.
Prove your worth
So, how can you and your staff prove your value to the health care organization before it's too late? Illustrate how much skill is involved in each of your jobs Take coding for example. Veteran coders often know dozens of codes, regulations and procedures for dozens of payers, and may even be more up to date than some software programs. How can the value of such an employee be quantified? By talking in a language upper managers understand dollars and cents.Idea: Prepare a report on the performance of your staff versus national averages, such as those pre pared by the HARA (Hospital Accounts Receivable Analysis) report. If your billing, registration or collection staff performs better than average, high light that fact and discuss how hard it is to meet such a performance level. Or, show how long it took to improve A/ R conditions at your facility and describe what would happen if your staff or budget were reduced.
Such a presentation could be just the wake-up call your CEO needs to prevent your hospital from be coming the next horror story told to your peers across the country.
Dan Heisel, Sr. is the chairperson of the American Collectors Association Healthcare Services Program, a Receivables Report editorial advisor, and president of Controlled Credit Corp. in Cincinnati. He can be reached at 513/921-4252 or via e-mail at dheisel@collector.com.
Reprinted with permission of Aspen Publishers, Inc., Gaithersburg, MD with Midwest Office in Brookfield, WI. "Health Care Collector. "
Bad Debt Does Impact The Bottom Line
By: David Zimmerman, Chief Executive Officer Zimmerman & Associates
Yes, bad debt does show up in the bottom line. No matter how it's treated, massaged, hidden, or buried in the sea of numbers - bad debt strips a portion of your profit.
It's time hospitals see bad debt for what it is and just how bad the damage is. Believe me, it' s bad. According to recent surveys, hospitals wrote off five percent of their gross revenue to bad debt in 1998. That's an all-time high.
While the nation's hospitals are watching their operating profit margins hover around the low single digit percent mark, they also are witnessing bad debt figures that have become staggering and concerning. The most recent fig uresfromtheAHAshowhospitalswroteoff$18.5billionto bad debt and charity combined. About $15 billion of that figure was bad debt.
It is estimated, based on our projections that hospitals could write off well over $20 billion to bad debt in 2000. Add charity write-off to that number, and you are looking at an uncollectible total that could reach nearly $30 billion. It was less than $3 billion back in 1980.
Based on conservative projections, the 2000 uncollectible figure could top $30 billion. It is safe to say bad debt is seriously hurting hospitals these days. Even at your own hospital your bad debt probably is in the millions of dollars each year and valuable revenue is unnecessarily lost.
In our opinion, the bad debt is about twice as high as it should be. Our experience shows most hospitals pay little attention to or are ineffective in collecting self-pay. Efforts to collect self-pay accounts most often are sporadic and ineffective. As a result, millions are written off each year at hospitals that should be cash and profit.
Reducing your bad debt and increasing the dollars collected has a direct impact on operating profit. More so even than improving the days revenue outstanding. If you reduce your annual bad debt by 50 percent, you can probably get as big a hit to your bottom line as you would by laying off 5 percent of all you full-time employees. Recent developments are causing even a greater negative impact on hospitals. Enough so that we would suggest you may want to take a closer look at your own bad debt write-off.
First is the issue of contractual allowances. As contractual allowances increase (a recent AHA Monitrend report shows that hospitals average close to 35 percent of their gross charges in contractual allowances), hospitals are seeing a negative impact on their profit. As contractual allowances increase, the financial classes where you can make a profit decrease.
One of those financial classes where hospitals profit can actually improve is in self-pay. As the HMOs, PPOs, Medicare, and Medicaid take a bigger bite through contractual allowances, collection of self-pay takes on added importance. Bad debt makes a direct hit in that profitable financial class. In fact, according to the AHA, 1998 hospital inpatient private pay increased more than 2 percent over 1997 - the greatest increase of any other financial class.
In tracking your bad debt, you may want to look closer at the percentages. For instance, the traditional percent of bad debt to gross revenue indicator may no longer be valid. A more practical approach to tracking bad debt may be to look at the percent of bad debt to net revenue.
In fact, it may be prudent to look even further at your self pay in terms of what portion is being written off to bad debt. If contractual allowances are eroding profit, collecting 97 percent to 98 percent of self-pay becomes a standard of excellence for which most hospitals will have to aim. Bad debt in too many hospitals has been overlooked for too long. It is presently too high in the nation's hospitals, too often overlooked and too important to the bottom line not to receive closer scrutiny and better results.
Bad debt at most hospitals has been too high too long. That's also probably true at your hospital. It doesn't have to be. It shouldn't be.
Author: David Zimmerman is chairman and CEO of his own health care receivables consulting group, Zimmerman & Associates, for the past twelve years In Milwaukee, Wisconsin. He is also the author of ten diverse books including his most recent effort, Unleash the Potential, Unlocking the Mystery of Motivation.
A popular lecturer known nation wide, Mr. Zimmerman is quoted regularly in a wide variety of news letters and national trade magazines and has been interviewed numerous times on television and radio.
The Debtor May Be Gone, But That Doesn't Always Mean the Debt is Dead
If you are informed that a debtor is deceased, be sympathetic and understanding with the party to whom you are talking. Find out the date and the place of death. Ask for payment in a tactful way if you are talking to the debtor's spouse or executor of the estate. Find out the name and address of the administrator of the estate and the attorney who is handling the estate. Then, if necessary, file a creditor's claim. If there is no estate, find out if there is a life insurance policy, how much it's worth and who the beneficiaries are.
According to the FDCPA, you may speak to the executor or administrator of an estate of a debtor who is now deceased in the same manner as you would speak with the debtor if he/she were alive.
Reprinted with permission of American Collectors Association, Inc. "Collector"
Medicare's Common Working file (CWP) by Joan Carr
The CWF is comprised of 9 localized databases, called hosts. Each host beneficiary claim history & entitlement information for the beneficiaries in its jurisdiction. Each beneficiary is assigned to only one Host site (usually the one that services the area where the beneficiary retires). Information included in the Master Record consists of MSP info & HMO info as well as Medicare information. In addition, Social Security files and IRS files are connected as well
The Common Working File has several purposes:
• To adjudicate Medicare claims.
• To ensure consistency between Medicare A & B claims (i.e. level of care submitted by a physician matches the level of care on the facility bill).
• To ensure claim information is consistent within itself (there are 38 field conflicts within the UB-92).
• To ensure duplicate claims are not paid (i.e. 2 ambulance trips for one benef1ciary occurring on the same date in 2 different states, hundreds of miles apart).
• Utilization parameters are maintained & can trigger FMR' s where applicable (i.e.: the Medicare beneficiary who goes to 3 different emergency rooms in one 24-hour period).
•Medical reasonableness & necessity parameters are maintained & can trigger FMR's where applicable (i.e.: a claim that bills for 34 increments of therapy on a single date of service - on claim due to clerical error).
Claims are adjudicated in one of three ways:
• Accepted (as is ) for Payment
• Adjusted & then Accepted for Payment
• Rejected ClaimIn addition a claim can be voided (previously paid, now rejected) or adjusted after posted.
The Common Working File is comprised of may edits:
• The 5000 range edits for entitlement - Edit 5700: bills span 3 or more 'spells of illness'.
• The 6000 range edits information flow & consistency when a patient moves from acute to sub-acute care - Edit 6010: no match on admission date, discharge date, deductible, etc.
• The 7000 range edits for inpatient and outpatient claims within the same time frame - Edit 7109: outpatient claim date greater than inpatient date minus 4 days - 72 hour rule has been violated.
• The 8000 range edits for claim consistency & field conflicts on Inpatient Claims (hospital as well as SNF) - Edit 8003: hospital coinsurance dates under applied.The Process:
• Provider submits a claim to the FI, Carrier or DMERC (thesatellite).
• The satellite then partially processes the claim (for missing information & errors on the claims).
• When the claim is ready for a payment decision (has all info necessary to make the decision), the claim is submitted to the CWF host that services that particular satellite.
• If beneficiary's info is at another Host, claim info as forwarded to that Host for a payment decision. If beneficiary in NIF (not in file) a file is created at the Host that put the claim in the CWF system.
• Based on the beneficiary's information in the CWF, the claim decision is made.
• The decision is sent back to the satellite for payment action.
• The satellite takes the payment action.Factors which impact the Process:
• The CWF is not completely Y2K compliant.
• The CWF Host info can be corrupted (erroneous info from another provider, Medicare card was stolen & is used illegally).
•Incorrect/incomplete in formation from your beneficiary.
• Claims not submitted sequentially (your initial claim before your discharge claim ALSO for sub-acute facilities: the acute facility discharge claim BEFORE your initial claim).An insight into the Common Working file can help you understand how you impact the process and take steps to ensure timely & accurate reimbursement. (Intermediary Manual Sec. 3800).
Preparing for Appraisals
Before you begin an employee's performance review session, check to see if you can say "Yes" to these statements:
• "I've spent enough time reviewing and thinking about this person's performance to ensure a fair and objective appraisal. "
• "I'll be able to cite specific examples of both strengths and weaknesses. And I'm sure I've selected the best example to back up what I'll say."
• "I know whether earlier appraisal sessions with this person have produced any behavior changes that we agreed to and that I expected to see by the time we met for this session."
•"I've thought about how this person might respond to any criticism I'll offer, and I know exactly how I'll handle it."
• "I've considered basic changes in the organization or in department activities that might have affected the employee's work performance."Source: The Fast-For ward MBA in Hiring: Finding and Keeping the Best People, by Max Messmer, JohnWiley & Sons Inc., 605 3rd Ave., New York, NY 10158.
Stress Security, But Do Not Threaten
Use appeals to anxiety as motivators for debtors on the physical, security and social steps of the needs ladder. It is a good appeal to use in certain instances because the state of being in debt produces anxiety of its own. Of course. you do not want to threaten debtors. When appealing to anxiety, the purpose is not to threaten but to point out the consequences of nonpayment. Use appeals to anxiety only as a last resort. It could work when other appeals have failed, especially with people at the security or social levels of needs. Among the ideas you can use to create appeals based on anxiety are loss of job and income, being denied future credit or paying additional interest and costs on this bill. A positive side of anxiety appeal (if there is one) is to tell the debtor that by paying it he'll no longer have to worry about his bill.
"You can't help but worry about unpaid bills. You'll feel a lot better when you get this off your mind. "
"Once you pay me I won 't call you anymore. "
"You need the protection of being able to get credit when an emergency expense comes up. If you get a poor payment reputation, you may not get what you will so desperately need. "
" Your job is more secure if you don 't have the fear of having your wages put under garnishment. " (Use comments such as these only if it is legal in your state, only if it is a possibility on that particular account and only if you already have a judgement. "
"You might be denied credit in an emergency .situation "
"You may end up having to pay additional interest and costs on the bill. " ( Use only if this true.)
" You need the security that comes from having taken care of your debts. "
"You gain freedom from worry about this unpaid bill. "
"When you pay this bill you will have no more worries and you will be free to enjoy life. "
"Having all your bills paid will give you the security to face and enjoy life. "
Reprinted with permission of American Collectors Association, Inc. "Collector"
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