Discover and read the best of Twitter Threads about #SMB

Most recents (24)

MUST READ: *Terrific* letter to @SecBecerra, @SecYellen, and @SecMartyWalsh signed by 97 Members of Congress and spearheaded by @RepTomSuozzi and @RepBradWenstrup.

They urge @HHSGov, @USTreasury, and @USDOL to not only reflect congressional...

...intent in their rulemaking by ensuring a balanced process to settle payment disputes between #health plans and providers, but also ensure an #IDR process that captures the unique circumstances of each billing dispute and does not cause any single piece of information to be...
Read 11 tweets
@HLPI_UHLC 1/ Frankly surprised at this article’s lack of substance beyond the basics—not to mention several of their statements which are either unsupported by data or experience.
1.Authors claim that the NSA will likely have little impact on physicians who do not engage in SMB....
@HLPI_UHLC 2/ —that’s not what the CBO thinks per their scoring of the E&C bill;

2.Outside of the biased studies out of Georgetown by the policy institute funded by the founder of Wellpoint health plan, there is not objective data that either the NY or NJ SMB models are inflationary.....
@HLPI_UHLC 3/ in fact, the NY DFS noted in their report in 2019 that folks there have saved over $400M—how is that inflationary?

3.Authors clearly like the CA model of benchmarking with no reference at all to the surveys done by the CA medical association of its members......
Read 4 tweets
#SurpriseMedicalBilling #SMB battle not over.
Insurers 👀 out 4 their pockets. 💵
🇺🇸 Medical care in peril
Patients need physician care.

⬆️ Dr-exit means patients lose
#MedTwitter : SMB bill must get implemented FAIRLY… Image
ER docs esp working like crazy during #Covid
This last 2 weeks 2 US ER docs took their own life.
@PamelaWibleMD put out wonderful sobering film
@Dr_RaulRuiz @SenBillCassidy @GOPDoctors, please be aware
We cannot continue having 400 physicians per year kill themselves
Author of this piece in @RealClearHealth is 100%!
Plaster on “academic,” “economic expert,” or “think tank” lipstick", you still have.... Image
Read 5 tweets
How to avoid losing money on your next website development/marketing project...

Thread time 👇
1. Hire someone or a group of someones that don't suck. Referrals and links of their prev. work help, but just talk to them.

If you don't like talking to them. Don't hire them.
2. Don’t tell your agency what you want them to do; tell them what you'd like to achieve.

Ask them what scams/sketchy things happen in the industry. If they don't know. They either aren't qualified to do the work for you, or they utilize prev. mentioned sketchy techniques.
Read 10 tweets
1/ In the "section by section" summary, several key #SMB changes from the 12/11/20 draft appear to have been made (subject to seeing leg. language): 1. the median in network rate must be "market based" instead of unilaterally determined by the health plan (++); 2. gov't payors...
2/ "public payor rates" cannot be considered by the adjudicator, & not charges (that was in the earlier draft); 3. Not sure if the tech. issues w/ claims that occur during the IDR being eligible for the next IDR were addressed--seems like they're trying to there; 4. stay tuned
3/ "trying to get there"... if I had a nickel for every typo in the past month....
Read 11 tweets
@JonnyJenk 1/ TY for your inquiry @JonnyJenk.

Factors drive #SMB: insurers’ narrow networks, high deductibles w/disproportionate cost-sharing for OON, physicians OON d/t take-it-or-leave-it contracts, health plans’ inaccurate provider directories. Patients are surprised by #insurancefail.
@JonnyJenk 2/ In terms of increased administrative burden that the current proposal would impose:

There will be a struggle for small practices to navigate the IDR efficiently and effectively, ensuring they have the resources to stay afloat while they challenge inefficient payments.
@JonnyJenk 3/ That is why AMA is asking to remove the 90-day cooling off period in the proposal - so that practices don’t have to hold claims for three months before they can pursue sufficient payment.
Read 6 tweets
1/ The “No Surprises Act” is deeply flawed. It should not advance in its current form. Work must continue to reach a meaningful remedy to “surprise medical bills” #SMB that keeps patients out of the middle and provides balance.

Here are several concerns w/ the current proposal:
2/ The proposal should require that the initial “interim payment” made by the insurer for out-of-network services be considered the plan’s offer for IDR, to incentivize the insurer to pay a fair initial reimbursement.

But, the proposal does not.
3/ The proposal should allow the IDR process to consider UCR and an independent charge-based database. Lest it be a form of price-fixing by insurers since the qualifying payment is indexed to the insurer-set in-network median rate (w/CPIU adjustment).

But, the proposal does not.
Read 17 tweets
1/ Ranking Minority Brady is supposedly meeting w/ W&M chair Neal in the am as a "Grand Bargain" is perhaps coming together after pressure from @SpeakerPelosi on #SMB--w/ no legislative language socialized 2 anyone in the doc community--2 of 4 corners in Senate remain opposed.
2/ Let's bolster the oppo w/ the simple message that we don't sign off on deals where there's no language + how about the bills that physicians passed in #NY #TX & #GA tens of millions of Pts are out of the middle due to physician lead bills--don't suggest "we're the party of no"
Read 7 tweets
1/ New #SMB data from #TX @TexasTDI --great & timely report--hot read as follows, data from 1/1/20 to 10/31/20--a. 32,036 IDRs filed, 86% from @EmergencyDocs, 7% anesthesia & 5% other specialties; b. Settlements (after IDR is filed)--clinicians are receiving +4.43X of the ....
2/ initial health plan reimbursement; c. when the adjudicator decides the IDR, clinicians are receiving 4.74X of the initial reimbursement from the health plan. The latter figure has come down from 5.3X when the IDR is adjudicated based on the first 6 month's report.......
3/ #TX model is working while not perfect for either side--costs for IDR are split and not loser pays but no law is perfect--TX continues to get an "A" @Reese_Tassey @drdanchoi @sonodoc99 @ercoderguy @amychomd @fuzzymittens @mass_marion @Valleus556 @TexACEP @szaafran ImageImage
Read 4 tweets
It is impossible for me to process the level of #facepalm I have just witnessed from @Bell's #business #fiber #internet alone, so you all have to share in this experience.

The fiber optic box for my #SMB internet service has a power supply with a built in UPS. Handy, right?
Internet is a critical service, and the entire device is under 25 watts, so building even a small UPS into the power supply will let it run for a very long time in the event of an outage! Great idea! Laptops and phones work when the power's out, so should the internet!
Wrong. The UPS is there for 911 phone service. So someone has actually gone to the trouble of designing a device that *knows* when the power has gone out, and continues powering the phones, but cuts the ~5 watts internet connection.

I don't have phone service. Just internet.
Read 13 tweets
Just shared a playbook with an older owner of a nat gas and water parts distributor in NY

Similar to one I used to grow cash, increase our multiple, and find a great buyer for 2 previous smbs

here is what I shared with him for his business 👇🏼

(As long as its typed, ill paste)
1. Write down how to do everything you do, knowledge-based or not. Write them using instructions as if you were delegating to someone with no experience.

This will help us bring new people as we grow.
Scale with fewer errors.
Package the business up for a buyer in 36 months.
2. repeat our model in more territories that are underserved.

These are easy to identify, and our service model will attract customers, with higher than industry retention.
Read 13 tweets

Stages of mastering #SMB operations.

Still going for me, so I'm sure this isn't a complete list.

First... 👇
2/7 Common Sense

Learning business basics. This is about all an MBA does for you. There are far faster and cheaper ways to acquire.

A few books, a few frameworks, a few conversations with owners and you are there.

Still, people pass common sense and end up in trouble
3/7 Psychology

As time passes you realize business basics aren't enough. You work with people, you sell to people, you buy from people. You need to understand people.

Once you get people, why they act, and learn to read them - you're performance will improve in all areas.
Read 11 tweets
The only way to solve #surprisemedicalbills is with a #fairIDR. But we need to get to the crux of this #SMB issue.

☑️ Everyone agrees to take #patients out of the dispute b/w #insurer & #doctor.
☑️ Everyone agrees to let the 2 parties negotiate the bills if the initial...

payment is deemed to be unacceptable.
☑️ Everyone agrees that there must be a fall back to a neutral third party (i.e., an #IDR entity).

⭐️BUT, what is disputed is whether this IDR will be a fair process where both sides can equally make their case for what is the most...

appropriate amount for that non-contracted service OR whether the IDR will be rigged and so unfair that the insurer will always win the dispute.

Many IDR proposals, sadly, are unfair, pointing the IDR to primarily consider the contracted rates #health insurers make up...

Read 12 tweets
Read this article from @KHNews @philgalewitz with great interest. A few questions, thread 1/x…
why does the web link say "surprise medical bill"? This was clearly an in-network claim, which, by default, can never be SMB? 2/x
The plan appears to be a high deductible plan, per the EOB. That's how HDHC plans work - even in-network, these plans have, well, a high deductible. Not sure how we got from that to the surprise medical billing part. 3/x
Read 6 tweets
William Sadleir, the former CEO & Chairman of movie production company Aviron Pictures LLC, was arrested for embezzling approx $14 million of investor money from the company to pay for a Beverly Hills mansion and other things.
Aviron was involved with distributing numerous films such as....
Here is says that the investor who Sadleir defrauded was Blackrock. Specifically, the BlackRock Multi-Sector Income Trust Fund.

Read 5 tweets
US Senate has agreed to additional CARES Act funding & is adding an incremental $75B to the original $100B for #hospitals & #physicians —resolving any doubt—“language remains the same as CARES Act”—allocation to rural hospitals & “hot zones” presumably TBD by @HHSGov —vote soon.
2/ SBA’s #PPPloans program slated to receive an additional $250B unrestricted + $60B for smaller banks + $50Bin EIDL loans + $10B in EIDL grants + $2.1B in SBA administrative expenses—really? Who wants to bid w/ me that we can administer this program for a paltry $1.9B? Who....
3/ said famously “a billion here, a billion there, and pretty soon you’re talking real money,”? Senator Everett Dirksen (R-IL) who has a Senate office Bldg. named for him in DC—how in the world do we plan to pay for all of this very necessary spending?
Read 5 tweets
As part of the #TweetStormTuesday was thinking about the less obvious opportunities from the #COVIDー19 #pandemic

👇A thread on why #Indian #B2B #SaaS companies can make the most of this tragic situation and help usher #SMB companies around the world into the #digital age.
1/ In this world of #lockdown and #WFH governments everywhere have been proposing large #economic #StimulusPlan packages. #COVIDー19 has caught many businesses off guard.
2/ While industries like travel, hospitality and real estate were unfortunately predictable casualties, many small/medium sized (SME) companies across sectors have been disproportionately impacted. These companies have put off digitizing operations and are completely gridlocked.
Read 9 tweets
1/ Several features of the not yet passed #COVID19 “3.0” bill (The CARES Act), pluses/ minuses—

1. -2% ⁦@CMSGov⁩ “Medicare sequester cuts” eliminated for duration of public health emergency (PHE)—ok thanks but could we get a complete elimination?
2. Extended ..

2/ ACA enrollment for uninsured in the federal exchanges;

3. Extension of 1.0 GPCI floor through 11/30/20— thx but why the cut off?

4. Feds covering Pt cost sharing for MCA, Advantage & MCD testing & treatment;


1. Both a “Sense of Congress” & Senate language....
3/ that would address #surprisemedicalbilling — what’s a sense of Congress you ask? No clue. Strength of statue? “Strength” of a UN resolution”? Not good if Congress punts entire issue to @HHSGov
Still reviewing Senate language—but are they frigging kidding us w/ cramming...
Read 6 tweets
Per @NoSurpriseGap lobbyist just now--Senate leadership has taken the Pallone/Alexander proposal off of the table for the 3rd #COVID19 relief bill (Phase 3 or 3.0) --social media made a big difference--congrats to all!! Pallone/Alexander are fully expected to try for May 22...
2/ Medicare extenders deadline & attach their proposal 2 that bill--depending on what happens w/ COVID19--@ACEPNow @EDPMA @ASALifeline @RadiologyACR @ahahospitals @AmerMedicalAssn @Reese_Tassey @GRKatz123 @ercoderguy @amychomd @drdanchoi @813JAFERD @mass_marion @NickSawyerMD
Read 4 tweets
@FrankPallone--while the #emergencyphysicians are defending us all against a global pandemic--& they're all we have--one of your fellow #NJ citizens & ED docs in Patterson, NJ ... Two Emergency Room Doctors Are in Critical Condition With Coronavirus
2/ is in the ICU b/c of #COVID19--& how sir are you honoring his defense of all us? You're in the backroom trying to attach a benchmarking #SMB bill 2 the latest relief package which per the @RANDCorporation will deplete between $230-700 BILLION from #hospital based physicians..
3/ when they do not have the resources they need today to respond to the pandemic--is that going to be your legacy? That you depleted nearly $1 Trillion from hospital based physicians when they stepped into the breach to treat us all at hazard to themselves, their families? ...
Read 4 tweets
#Campaign in tweets - @Guardicore Labs in a new tradition; we find the attacks, you get to know them and learn the attackers' tricks and techniques. This time, let's get familiarized with "Lemon_Duck", a #cryptomining campaign involving a sophisticated #propagation tool. 🍋🦆
Before we start: all scripts, binaries and IOCs are available on our github repository. In addition, malicious IPs, attack servers and domains appear on @Guadicore Cyber Threat Intelligence portal. You're welcome to take a look :)……
Lemon_Duck starts by breaching machines over the #MSSQL service or the #SMB protocol. We'll focus on the MS-SQL flow. Once inside the machine, the attacker enables #xp_cmdshell to run shell commands. It will take only a single command line to trigger the rest of the attack.
Read 12 tweets
1/ Today I’m nervously hitting the publish button on a big project. For the past month I’ve been obsessively analyzing over 150,000 small business websites to find out what makes them tick. That’s roughly 1% of all small businesses in the US.…
2/ I call it the 150k Small Business Website Teardown 2019. A lot of folks helped out with this gigantic project. Special thanks to @danaditomaso, @darrenshaw_, @davidmihm, @JoyanneHawkins, @lauratroyani, @randfish and @RobOusbey for putting up with my questions.
3/ To complement the crawl I ran hundreds of Google searches to see how these websites stack up in the rankings. I fetched #PageSpeed scores to see which sites were speedy and which were slow. Ultimately I collected over 300 data points for each website.
Read 13 tweets
Can't Save Photoshop Files on Shared Folders Through SMB
Problem - saving a PSD on a shared folder results in this error:
“Could not save because write access was not granted.”…
Happens even with correct permissions.
The fix?
In Finder:
• Hide Preview when viewing files.
• Hide Preview -> ⇧ + ⌘ + P
• If Show Preview is enabled, de-select the file you’re working on in Finder before you save.
#Photoshop #Workflow
Also, in #Photoshop:
• Preferences -> File Handling -> File Saving Options -> Image Previews -> Never Save
#SMB #macOS #Workflow
Read 11 tweets
"I'm afraid to discuss my business ideas because I'm afraid someone will steal them. What do I do, Shadeed?"

Good question. Here are 7 ways that you can protect your #business ideas.


#smallbusiness #startup #smb
Protect your business idea #1
Non-disclosure agreements. (NDA)

What is a NDA?

A legally enforceable contract that binds confidentiality
between a person holding information with the person who
is receiving it.

You sign NDA before you tell the details.
Protect your Business Ideas: #2
Trademark your Name

What is a trademark, Shadeed?
A symbol or words that are legally filed to represent a product or company.

Where do I file my trademark?
Apply online here:

Read 10 tweets

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