Social Media: Why Do Some People Look Towards Social Media To Give Them Approval?

In the beginning, it could be said that people generally used social media to get in touch with their friends and family; the people who they actually knew. But as time has passed, this is no longer why a lot of people use it.

As for the people who only use it to stay in touch with their friends and family, it is likely to be no different to how it was when they first started using it. Now, they might notice that the site they use no longer looks the same as it did or that others use it differently, but that could be as far as it goes.

Friends

If one only added people who they knew when they first started, there is the chance that this is no longer the case. Even if they have only met someone once, they could still end up adding them to their ‘friends’ list.

When this takes place, they might only be thinking about how this will have an effect on how other people perceive them. For example, if one has a certain number of ‘friends’, they can end up being seen as popular.

One Purpose

What this can then show is they are more concerned with how they look than they are with connecting to others. This doesn’t mean that they won’t talk to others; it just means that it is unlikely to be their priority.

And if one has this approach when they go online, there is a strong chance that they have a lot of ‘friends’ who are just the same. In addition to this, it might also be important for them to look right in other ways.

The Perfect Life

What this can then mean is that they will want other people to believe that they live the ultimate life. As a result of this, they are going to have to be very careful when it comes to what they share.

It will be vital for them to share pictures where they are having a good time, and being in exotic locations will also help. If one looks as though they are enjoying themselves in a warm country, it can be normal for people to believe that they lead a good life.

The Right Image

Along with this, one can also have the need to look right, and this is going to be relatively easy. Not only can they choose what pictures to upload; they can also change how they look.

Through using the right angle and the right light, one can take pictures where they look their best. Once this has taken place, one can make a few major or minor changes to the images.

An Act

In this sense, it might be accurate to say that when one uses social media, they are putting on a performance. This is their stage, and they are choosing to be someone who has their life together.

But like someone who acts in the real world, they are not going to be able to truly connect to anyone when they are playing a role. Who they are has been put to one side, and their needs are going to end up being unmet.

Approval

When one has this approach when they go online, it is likely to show that they have a strong need for approval. If their ‘friends’ don’t give them the kind of feedback that they need, they could end up being in a bad way.

However, this doesn’t mean that this is the only way they will come across when they are this way. For one thing, one might not try to create the impression that they lead the perfect life, and they might not even edit their pictures.

A Number of Ways

One could receive the approval they need through posting funny videos or memes that make people think about the world differently. What this shows is that one is not going to need to rely on their appearance and neither are they are going to need to travel all the time.

And as long as they have some kind of device, it can allow them to receive approval whenever they need it. It is then not going to be necessary for them to delay gratification; they can fulfil this need instantly.

A Closer Look

When it comes to the people who behave in this way and the people who don’t, it is clear that there is a big difference. What this can show is that the people who do need a lot of approval are emotionally dependent on others.

As they are unable to handle how they feel, they need other people to regulate their inner world. But this is not the only thing that can be involved here; they can also be in a position where they haven’t got any close friends.

One Direction

If they had people around them who they were close to, they would be able to receive the approval and the validation they need from them. And through having the ability to regulate their inner world, they wouldn’t depend on other people to do it for them.

The reason one doesn’t experience life in this way and looks towards social media to give them approval can be the result of what took place during their early years. This could have been a time when they didn’t receive the kind of care that they need in order for their brain to develop in the right way.

Conclusion

The ability to regulate their emotions wouldn’t have developed, and this would have stopped them from feeling comfortable enough to reach out to others when they need them. Ultimately, no one is their own island, and this is why human beings need other people.

But when one doesn’t receive the right care, it can set them up to be dependent on others, or to go the other extreme and become extremely independent. What this emphasises is how important it is for children to be brought up in the right way, and for there to be help available when this doesn’t happen.

Prolific writer, author, and coach, Oliver JR Cooper, hails from England. His insightful commentary and analysis covers all aspects of human transformation, including love, partnership, self-love, and inner awareness. With over one thousand two hundred in-depth articles highlighting human psychology and behaviour, Oliver offers hope along with his sound advice. His current projects include ‘A Dialogue With The Heart’ and ‘Communication Made Easy’.

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What Items Are Considered Fashion Accessories And Why Are There So Many?

Have you been trying to upgrade your gear as in your appearance of what you wear? If you are then you will need to start looking and thinking about what your style is and find that type of brand that you like and stick with it for awhile.

As it comes to fashion and accessories you will find that there is a diverse variety of different types of accessories. Fashion accessories, like clothing, shoes and others come in different shapes sizes and more. There are clothes and other fashions made just for that type of person it can be found from kids to bigger adults.

One of the most desirable types of fashion accessories is that of jewelry. As it was stated above fashion accessories are for all types and ages of people and genders. For kids and teenagers and older people they like necklaces bracelets and that such with charms and colors. Men usually like necklaces with large charms or nice watches, while women tend to like rings with stones those of diamonds, bracelets, anklets and many more.

More types of fashion accessories include handbags or purses. Most teen girls and women like to carry all there stuff in one of these. A purse is just used to carry their stuff that they need with them and handbags are just larger than a purse and can hold more. Handbags and purses come in many different styles, shapes and sizes that is why many girls and teenage girls and older women have a variety of these.

To go along with purses and handbags traveling bags are now popular as well. Travel bags are sort of the same as a handbag but are made for men and women. A travel bag might even have a smaller handbag inside to be used to bring on to the plane with you.

Shoes also are a prized possession of many types of women. A lot of women have to own a different pair of shoes for every outfit. Due to those reasons is why women like to shop a lot. So if a woman has a lot of shoes but not enough clothes she’s going to go out and get enough to match them.

More pieces of fashion accessories are belts for both men and women. Men and boys usually wear belts as means to hold up their pants but women wear them as fashion and are not just to hold up their pants. Women’s belts arrive in many different shapes sizes styles and colors. These belts that women wear are just for fashion and are not made for any specific reason except to display their sense of style and fashion.

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The Meaning Of Quality In Health Care

The process of receiving health care services at the correct time in the appropriate way and to get the best possible outcome is defined as quality health care.

Six attributes of health care quality

• Safety – Care should not harm any patient.

• Patient centered – Individual needs should be taken care of when providing care.

• Timely – Care should be provided exactly on time.

• Effective – Care must be based on evidence.

• Efficient – Wastage of time should be reduced.

• Equitable – Equal care should be provided to every patient.

What is quality health care?

The meaning of quality health care is not the same for all people. According to some patients, quality care is to consult a doctor, to get proper treatment from the staffs of a hospital and to have a physician who can spend much time with the patient. But all these things are secondary. Clinical quality of care is the most important thing because more lives can be saved by providing evidence-based and high quality care.

Does quality equal safety?

Yes, quality equals safety. The quality of care is to be improved by the health care providers because it can save more lives of the patients.

How is health care quality measured?

Outcome indicators and process indicators are the two ways of measuring quality of care. Timelines and baseline practices are measured by process indicators. Complication rates, mortality rates and infection rates are measured by outcome indicators.

These indicators can be looked at by the consumer to compare the hospitals. National accreditations, recognitions and state of the hospital should also be looked at by you to measure quality.

What are quality measures and quality indicators?

The process of converting the medical information of a patient into percentage or rate to analyze the quality of care provided by the hospitals to their patients is called a quality measure. You will be given information by quality measures about how the patients are provided care by the hospital. This quality information can be used by you to compare the quality care of different hospitals.

What role do nurses and doctors play?

A very important role is played by the doctors and nurses. Quality care should be provided by all the nurses and physicians, clinically and satisfactorily. All the staffs in a hospital such as the receptionist, scrub nurse, hospital administrator, physician and the X-ray technician are responsible in providing quality care to all the patients.

Remember all these features when you will go to get quality health care from any hospital.

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The 8 Questions You Must Ask Before Working With Any Business Credit Building Company

There are few business credit building companies out there, however, those that are out there are taking advantage of the lack of knowledge from the general public regarding business credit and how to get a business loan.

DON’T LET THEM RIP YOU OFF!

I’m going to try to show how to get unlimited capital for your business…

Without risking your personal assets, lowering your personal credit score, or damaging your personal credit history

These 8 Simple Questions will ensure Your Success Building Business Credit when looking for a Small Business Loan

There are simply too many people who hire business credit building companies that are not happy with the results. Before choosing another company, if you ask these 8 questions you will be assured that you will be working with a legitimate company who can help you build business credit and more importantly get the small business loan you seek. Getting that business loan is after all what you’re looking for, isn’t it?

Why is it so important to work with knowledgeable advisor? Why can’t you do it on your own? The Fair Credit Reporting Act does not apply to the business credit bureaus; this means that if you make a mistake, skip a step, try and take a short cut, your business credit file can be “Red Flagged.” This means your company is prohibited from receiving credit and perhaps that elusive business loan.

There is a proven step-by-step process that MUST be followed if you plan on properly building your business credit and getting working capital. If you don’t follow the proven process then you can be put into the “High Risk” category. When that happens, no lending institution will give you a cash advance or small business loan and there is nothing you can do to remove it.

Make sure to choose a honest credit building company that has the knowledge, experience and proven systems to support you, before you decide whom you will work with, make sure to ask them these 8 vital questions.

Question #1

Will I be obtaining only trade credit or CASH credit?

Be careful, there are a number of companies out there that will only help you obtain trade credit. Trade credit can only be used with the individual creditor, and nowhere else. This is great if you need $3000 of paper products, but is useless if you need payroll loans, inventory loans, or simply to cover business expenses or expand your company.

And if it is CASH credit, will I always need to personally guarantee the application?”

If the company says you will always have to personally guarantee all types of credit – then you are NOT receiving the full benefit of business credit. Keep in mind, the solution must introduce you to business funding services that will not require a personal guarantee, however these non traditional lenders will still be checking your personal credit and need your social security number. They do this to stay in banking compliance.

Question #2:

Will a trained coach show me, step by step, how to incorporate my business and build business credit with an eye to getting that merchant loan or business loan?

My guess is that if you wanted to figure out the intricacies of incorporating your business, and building corporate credit on your own… you would have already done so. (I’ve done it. And believe me… this is NOT stuff you want to muddle through on your own.)

So if you won’t be receiving step-by-step instructions supported by a trained credit coach, resulting in a predictable successful outcome, call another company. (I’ll spell out each step for securing business loans without traditional personal guarantees in crystal clear detail in a later article).

Question #3:

If I get stuck while I’m taking all those necessary steps, will I have to pay you hundreds or even thousands to help me figure it out?

Many companies charge low fees up front and continue to tack on heavy, additional charges each time you call or write for help.

Make sure they deliver everything you need to know to secure a bad credit business line of credit or high risk business loans, all without the traditional personal guarantee. Make sure you will have access to a dedicated coaching advisor and who places no limits on how often you can speak with them.

Question #4:

Will you have the ability to set up capital loans, and monitor the development of your business credit score with all major business credit agencies all within your coaching platform?

Why work with an advisor who is trying to blindly lead you!

Question #5:

When companies promise to get you cash credit, ask them this pointed question: “What type of paperwork is required to get cash lines of credit?

Beware of companies that say it is not required to furnish any financial statements, tax returns, business plans, bank statements, etc., to obtain a small business loan without a traditional personal guarantee. When it comes to getting approvals for cash advance without a traditional personal guarantee, you will need to show that your company is financially responsible and you do this by showing it earns revenue, pays its bills on time and has establish good business credit.

If the company tells you that you can obtain this type of financing without providing any real documents, don’t bother working with them, they are not being honest.

Think about it, is a lender really going to give you hundreds of thousand of dollars without a traditional personal guarantee without you having to show them that you are a “safe-risk?” Over time I will show you exactly what you need to do in order to become a safe risk and secure a small business loan.

Question #6:

How are your coaches paid?

This is a really important question! How would you like to work with someone that could care less if you obtain the business loan you desperately need? Think about it!

Question #7:

When it comes time to apply for a business loan, are you going to pass me off from lender to lender?

This is another very important question. Virtually every credit building company will, when it is time to apply for a business loan, pass you off to one lender to apply, and then tell you to go and apply at the next lender and so on. They literally end up sending you on a wild goose chase and just hope that one of the non traditional lenders can obtain capital loans for you. Does this sound like something a real business credit and financing expert would do?

Question #8:

What kind of a guarantee do you offer?”

It’s critical to get the specifics about guarantees. Because most companies that offer guarantees or promise only that your corporation will get a 80+ Paydex score. While this is a start, it’s not good enough -

If after completing your program, you should have:

Corporate Compliance and documentation review

D&B file and a D&B rating

D&B Paydex Score

Business credit file with Corporate Experian with an intelliscore

Business credit file with business Equifax with the appropriate business credit score.

Trade accounts and/or Vendor Accounts with and without a personal guarantee.

A Business Credit that can be used to leverage financing opportunities

This is not, by any means, a comprehensive list of all the questions entrepreneurs should ask when it comes to building corporate credit. But if you address these costly and dangerous errors, you will be on your way to building a safe, secure, and financially sound business-the business you always dreamed of!

Hopefully, these 8 questions will help ensure that you work with a credit building company that will be honest, upfront as well as help you successfully establish your business credit and leverage it into new small business loans and opportunities for your business.

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Fulfilment by Amazon and How It Helps Explode Your Business Profits

In this modern society where almost everything is digital, it is hard to believe that there are still those who prefer traditional methods, such as in the field of advertising.

Online advertising has been a hit in the last decade. Internet marketing has taken over businesses by storm and doubled their revenue. However, some people still see the field as unnecessary and taxing so they try to convince others to veer away. Below are other reasons why some individuals dislike online marketing:

Inability to adapt with technology
A person may refuse the method because they may not be technology savvy. They are afraid that technology is hard to monitor or manipulate so they choose to stay manual.

Mastery of craft
A lot of traditional people spent years perfecting their craft, so they believe that their capabilities are sufficient. Online marketing is a threat to physical advertising because it minimizes the need for logistics, hence the repulsion.

Less Jobs
Some people think that digital work reduces employment opportunities due to computers replacing manual labor. Only a handful of people are necessary to make internet marketing work.

Information Breach
Putting everything on the internet is a risk for hacking or information leakage that’s why many are skeptical about it. Online marketing requires a substantial amount of data that can be easily stolen or erased.

Lack of Equipment
Many marketers don’t have reliable internet or computers to handle critical work. Manual advertising is easier to delegate and segregate, so smaller businesses prefer it.

Lack of Empathy
Advertisers believe that online marketing is not good for client relations because it promotes a more detached form of communication and a robotic response. Manual advertising is more personal so it is easier to convince people.

Lack of Authenticity
Marketers are wary of online advertising because people nowadays are harder to convince, especially in terms of the authenticity of a product. Since everything can be manipulated or edited, they would have to work more to attract clients.

Population of Non-internet users
A big percent of the population is still manual so it is impractical to promote online marketing in these areas. Online commercials only work with regular exposure but if the audience only uses the internet a few times then it is a wasted effort. Manual advertising is beneficial when people are more inclined to support physical efforts or are part of a community network.

Promotes Mediocrity
Senior marketers believe that online marketing encourages laziness in the younger advertisers because most materials can be recycled, edited or rehashed. Marketing is a skill developed from experience and virtual training may not be enough to develop and create a better breed of advertisers.

Technology is a waste
People believe that using gadgets and computers are harmful to the health of workers so they don’t encourage the employment related to such. Manual advertising promotes brain functions through practice and personal relationships development. It is important for some people to backlog technology to help the environment.

Despite the many reasons why people may talk you out of online marketing, it is still undeniable that this form of marketing has a lot of potential. Learn how you can maximize the web when it comes to marketing your products and services, so you can expand your reach.

John Richards has many years of experience creating and developing books, eBooks, manuals, and videos, on a variety of subjects, including online wealth, pet care, Internet marketing, direct mail, health and wellness, and CD/DVD distribution service. John’s website provides ideas and practical advice for people who want to enjoy the rewards of earning an income from home using simple websites.

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Crony Capitalism – How Bad Has It Gotten In The US?

We all know the problem of the revolving-door in our political leadership and bureaucracy. Folks are in and out of government, keep their contacts and make a fortune from the known reality: it’s not what you know but whom you know. The problem with all this is exactly what Adam Smith warned us about; the incestuous relationship between government and business. Corporations in the US are large and powerful, and have and hire the best talent, retain and control endless resources – these corporations do not NEED government favors, nor does their executive leadership, they are doing fine.

To secure the most optimum efficiency in our economy, we must keep the free-market as free as possible, when we allow a skew due to political favors or inside information, or allow lobbyists to the run the table, often at the expense of the people all we do is prove the cynics correct that; the game is rigged. Perhaps this is why Donald Trump has promised to; Drain the Swamp. And, he’s human too, I have no doubt he will drain the left-side of the swamp first, but it’s still a good start. The trick is to set a new set of rules, lay down the letter of the law, and move forward.

In Harvard Business Review, December 2013 Issue, there was an interesting article titled; “Unwinding Inequality” and in that article was a quote by Angus Denton; “When people use their success to change the rules in their favor, that success is no longer to be celebrated.”

“Yes,” I say, “Indeed.” But let’s take this argument to a higher level shall we. First, I find it rather hypocritical to read of this in the Harvard Business Review, as most there believe in the concepts of Adam Bellow who wrote the book “In Praise of Nepotism” which might explain why all the Supreme Court Justices went to Ivy Leagues, Harvard or Yale, some both. Worse, look at the academic records of the last 5-presidents of the US, and a darn good many senators, and heads of major bureaucracies, corporations and NGOs.

Second, if we dissect that quote, it talks about “success” and the concept of changing the rules once one, a group or corporation gains in the synergy of their own success. Well, isn’t this really the same challenge with guerrillas or terrorists attacking the status quo, authority and government – if they succeed, they are then in control and then they inevitably seem to use the same so-called tyrannical methods of ruling that their predecessors had before they ousted them – thus, the word “revolution” as it just goes round and round as another group comes along to then unseat their new authority.

Now, one can see a similar process in business and industry. For instance, read;

1. “Rule Makers and Rule Breakers,” by David Garnder
2. “First Break All the Rules,” by Marcus Buckingham and Curt Coffman
3. “The Innovator’s Dilemma: The Revolutionary Book That Will Change the Way You Do Business,” by Clayton M. Christensen

Once the company garners market share synergy, and industry status, it moves to change the sector’s associations to lobby to get the rules and regulations changed to its way of doing things blocking future disruptive competitors from coming along to change the industry just as they had to get to where they are today.

The easiest way to do that is through crony-capitalism, campaign contributions, public-private business partnerships, which also leads to selling goods and/or services to the government and secure a free flow of money to further continue their dominance by playing with the political elite – who all went to Ivy League schools. Thus, I find it so fascinating that HBR (Harvard Business Review) had the gall to even publish that article – due to the obvious hypocritical nature of the norm which comes from that elitist institution. Please consider all this and think on it.

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Personals Like Craigslist – But Better!

If you go looking, you will find personals like Craigslist all over the internet. Most sites offering online classifieds have a personals section nowadays. They all suffer from the same problem, however. And this problem will usually result in you wasting time and often losing money.

This article is here to give you fair warning about the drawbacks to using these internet classifieds and also a solution that is a much better alternative for you to find a date or casual encounter.

The problem with personals like Craigslist is the huge number of con artists using the service to market dating products. If you post a personal ad, you will receive dozens, sometimes hundreds of responses. The majority of these emails will come from clever internet marketers, posing as attractive women who want you to join a dating service in order to meet them.

Some of those emails will come from real women, true, but how are you to tell which ones are real and which are fake? There is no way. Which means, though the personals at Craigslist are a good concept, they tend not to work for most of us.

The solution that most people overlook is to use a big-name dating service. Most people are put off by these services because they think you need to pay to use them. Not true. You only pay for premium features. And, let us face it, if you do pay for premium features, that is probably a small cost to pay for what you get.

And what do you get? Well major dating sites are personals like Craigslist in many ways. You can join for free and use many of their services without cost. You can make searches of people in your area and read what they are looking for.

You get a lot more, though, than that offered by personals at Craigslist. You get real people, no internet marketers trying to con you; you get to see who is online and who is offline; you get to contact people with instant messages; you get to add them as friends and view their photo albums.

So, all in all, they represent a much better alternative. They offer far more features, many of them offer free accounts, and when you get an email from a woman you know that she’s real, and not some clever con artist!

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Why Computer Hardware Is Important

In this day and age, it is hard to deny the influence of technology in our lives. We live in an era where pretty much is automated and computerized. And amidst all the technological advancement that humankind has achieved, one important device has been created that will only sure to become more relevant to our lives as technology progresses, the computer. No one can deny that computers are now an essential part of our lives, the same way a cell phone and television does. It is safe to say that in this day and age, having no computer would be an inconvenience. Which is why it is important that we know the how our computer works so that we would be aware of the things that we should do in case it stops working. The hardware of the computer is considered to be the most important because without it, it will simply not work.

Simply put if you know how to handle the hardware of a computer and know each of their function for the unit, then you can easily determine what the problem is in case the unit stops functioning. In order to be familiar with basic computer troubleshooting, then you also need to be familiar with computer hardware. A good example of this is the memory of the computer (RAM). All programs and applications that are ran in a computer needs memory. Without RAM it simply won’t function. Aside from that, even if you have a RAM but it does have the specifications to keep up with the programs that are being ran, then the operation would be slowed down to a crawl. So when it comes to computer hardware, you have to make sure that it is not obsolete, so you need to upgrade depending on what sort of program that you are usually using.

When handling computer hardware, you have to keep in mind some safety measures so you can manipulate the unit safely. Before opening any computer cases, you have to make sure that the unit is unplugged or you might risk electrocution or shocks. While checking your hardware components, always check for damaged parts because that is most likely the one that is causing problems. When inserting components and parts, you have to remember that if it doesn’t fit, then most likely you are inserting it on the wrong slot. If it does not fit, then do not force it or you will risk breaking the component. Before touching any parts inside the unit, make sure that you discharge yourself first by through a grounded metal object or you can use an anti-static wrist strap or mat which is sold in stores for cheap.

By knowing and analyzing every computer hardware part you will know about its importance and if it ever breaks down then you can perform the proper troubleshooting steps. Every hardware component is important for the computer’s operation. The performance of your computer largely depends on how good your hardware is, so be sure that they are always in good working condition.

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Promote A Home Cleaning Service With Promotional Items

There is no better, economical, and effective way to promote your home cleaning service and to increase sales is to use the tried and tested promotional method of giveaways and gifts. Promotional products are an effective and low cost way to grow the brand recognition, within the community and even outside it, for your home cleaning service. Whether it is a new business or a trusted and established service with high visibility in the community, your cleaning company is sure to attract additional home cleaning jobs, and rope in more clients, with the wise use of a range of promotional marketing items.

A start-up cleaning business can promote its services through these handouts, while a larger cleaning service, offering a range of options like full house cleaning, or window and floor cleaning, can also benefit from such drives. Promotional item giveaways can help to rapidly expand the customer base of any home cleaning service. Ranging from promotional items like magnets, to larger giveaways like kitchen utensils or household and cleaning products, giveaways can be very useful in promoting your services to existing clients and their friends and neighbors.

Items such as computer brushes or even screen cleaners imprinted with your name and logo not only bring the shine back to the clients home, but remind them to come back to your when spring cleaning time comes around! Choosing a handy promotional item ensures that the recipient clients are able to have it right in front of their eyes, usually on their desks or counter top. What this means is that your brand, and the services you provide, also remain in the forefront. This is one of the most effective marketing campaigns home cleaning service can engage in, and it is not the least bit expensive or even time consuming. Promotional goods and items are the perfect cleaning business marketing campaign and they are easily carried out, requiring the bare minimum of personal input and working time.

Promotional items can be anything from umbrellas and paperweights to pens and magnets, from key chains to cleaning supplies, and all of them have the power to make your brand popular for a much lower investment. Significant value as a branding tool, and lower investment in terms of money, time and effort, make them a better way of publicizing your brand than the more traditional forms of advertising. Magazines and newspapers, television and radio ad spots, all pale in comparison, with promotional products giving you the same impact level at a noticeably lower budget.

Get your promotional cleaning services give away from the wonderful collection at Action Printing Inc are the perfect way to get your home cleaning business brand and logo out into the wide world? From the small and handy to the larger and more useful-around-the house items, there’s a range on offer to choose from. For a much smaller budget than needed for any traditional mode of advertising, you are sure to get noticed, and both satisfied customers, and their friends and neighbors will be lining up in droves to offer you their business!

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Medical Records Retrieval for Law Firms

• MODERN MEDICAL RECORDS RETRIEVAL SERVICE – AUTOMATION, COMPLIANCE, SAVINGS

The modern Medical Records Retrieval (MRR) service is a combination of modern web-based technology and a rules-compliant outsource solution. Historically lawyers and their staff would have to set aside a portion of their time, often a lot of time, to capture necessary information for cases that involved medical records. It’s not that the process is complex. Quite the contrary, every attorney, paralegal, and litigation-support person knows exactly what needs to be done.

It may appear simple, but it is a very manually intensive process. Someone at the firm must acknowledge the need for the records. Necessary forms must be completed to ensure compliance with a myriad of laws (including HIPAA), which the firm and often the patient (who may or may not be the firm’s client) would need to initiate a request. Then, the firm must track the progress of the request, and eventually receive, review, and organize the results, or note that there were no medical records available related to the matter.

To support the business of running a law practice, sophisticated and affordable software tools include new client/business intake, workflow automation, and conflicts management. Vendors who provide early case assessment tools and e-discovery-based technology-assisted review have begun to offer solutions for small firm and solo practitioners. In this article, we will show you how you can improve productivity, lower costs, and better manage billing for MRR expenses.

How Medical Records Retrieval Services Work

Here’s how a typical MRR service works for a small firm/solo practice. One of the firm’s employees logs into a secure, encrypted website. He or she then submits an order outlining the patient’s information, the records being requested, and any other data necessary to complete the request. What happens next is truly a game-changing activity. Instead of the firm’s billable resources chasing record requests from hospitals, doctors, and other healthcare providers, they go back to doing other, productive work, while the MRR process self-executes, and eventually provides you with the requested information and documents or informs you that there were no responsive documents.

Questions Regarding MRR Services

The availability of MRR services presents all attorneys, but especially solo and small firms, with the following important questions:

• How do you start with an MRR service?

• How are the record requests processed?

• Is this process HIPAA-compliant?

• When and how am I alerted to the status of my requests?

• How do I distribute the costs/fees associated with outsourcing medical records retrieval?

Choosing Your MRR Provider

To reduce the risk of choosing the wrong MRR service, consider the following best practices:

1) Ensure that the MRR service can prove secure access to its website (and your records) via a login and password.

2) Understand the MRR service’s processes to ensure protection of privacy.

3) Understand its service level agreements, which explain their process and anticipated turnaround time.

4) Verify that the MRR service has experience with expediting record requests by requesting a list of reference clients.

5) Review the process by which you and/or your staff are notified of updates, including record availability or notice of “no record found.”

6) Ask for the MRR service’s price schedule, preferably in a format that will permit you to do an apples-to-apples comparison of the fees of other MRR services.

When possible, a dedicated MRR service is a better choice than a firm that offers a multitude of legal practice services of which records retrieval is only a small subset of their overall business.

Getting Started with the MRR Provider

Upon choosing your MRR provider, the steps to starting to work with the provider are straightforward and similar to those when signing up with any on-line type of service:

• The firm identifies the approved personnel who are authorized to access the secure system.

• A unique user ID is created for the firm at this time, with a strong password required for all future access.

• Often, this is also the time that billing information is provided, and thus a financial account with the firm and MRR is created for future invoicing.

• Each authorized person completes a new user profile and sign-on request. The user must provide email and phone contact information.

• It is the responsibility of the law firm to notify the MRR as soon as possible in the event that an existing authorized user should be removed from the access control. The MRR should remedy and respond as soon as the user access has been removed.

• While the use of the MRR site should be quite easy for most users with minimal training, additional site support generally is available from the MRR’s services personnel via phone or email request.

Safeguarding Privacy

No matter how beneficial the technology, the firm must ensure compliance of federal and state HIPAA guidelines and any ethical rules about maintaining client confidences. Therefore, they must ensure that the MRR service collects, hosts, and provides access to client(s) records while maintaining compliance with privacy guidelines. Note: This should be part of your due diligence when selecting a provider.

The MRR Service should comply with Federal and state privacy laws. MRR services should keep up to date with changing rules of privacy such as the HITECH Act.

MRR agreements should expressly state that no personally identifiable health information (PHI) can ever be used for non-business related activities such as marketing and/or sales lead generation.

Record Processing

Once you have chosen an MRR service and set up your account, obtaining medical records is relatively straight-forward:

• After you enter a request into the system, the MRR service creates an MRR record request connected to the unique ID of the requester (the specific user at your firm), and confirms receipt of the request via an email.

• A reviewer is assigned to assess the necessary actions to fulfill the request, and will notify the user of any questions regarding the record request. In some states, including California, an electronic request can be executed from the MRR service to the healthcare provider, eliminating the need for paper-based transaction.

• The provider then tracks the request, and conducts any follow-up communication by any means available, including email, telephone or in-person visits if necessary, to acquire clear copies of records requested.

• If the record is available and legible, it is scanned into the secure web-based system for access by the user. Otherwise, a “no record found” is annotated to the request, and communicated back to the user.

Communication Is Key

Nothing can be more frustrating to case management than waiting for needed information from a third party. The MRR service must not only forward the record request to the healthcare provider, but also must provide the firm an ongoing and timely response regarding status. Each record must be tracked in real-time with detailed notes from the MRR agents. The MRR service should send alerts if additional information is required, provide replies via email, and deliver the link to download and/or view completed requests as soon as the records become available. Again, during the selection process, you should ascertain the provider’s practices regarding communications, and include them in the contract.

Speed Is Critical Too

Obtaining the medical records timely is critical, whether to respond to discovery, to make or oppose a motion for summary judgment, to get an expert up to speed, or to settle a case. A reliable MRR service will offer a quick turnaround. They have the experience working with medical locations to obtain records faster than a law firm’s in-house staff. After all, a law firm staff member may encounter (or, in truth, may feel like they have gotten stuck with) the occasional medical record search, but the MRR service is a specialist in the process of collecting information, including “no records found.” So, the MRR service’s very job is obtaining medical records, and therefore will have the process down to a set of specific steps, and can support their clients via a web interface.

Relationships With Healthcare Providers

Sometimes hospitals, physicians’ offices, and other healthcare providers may treat the occasional request by an attorney for medical records as an inconvenience, not respond as quickly or perhaps as completely as the attorney or client would like. A smart MRR service will develop long-term relationships with healthcare providers and their staff to get the data needed promptly and efficiently. This will improve the quality of the document production, reduce its cost, and speed the process up.

Database Strength

Medical records often can be in a different location or city than the healthcare provider. For example, billing records for hospitals are usually in an offsite facility, sometimes in another state. With the advent of electronic records, more healthcare providers are centralizing their records offsite with the umbrella company of their medical group/hospital. Without the information on how and where to request records, in-house staff can waste valuable time sending requests to the wrong locations or having to spend the time to find out where to send the requests. A strong database on where and how to request records from healthcare providers therefore is key to save time, ensure complete result, and save money. MRR services have the incentive and the resources to develop such a database. Law firms, especially solos and small firms, do not.

In addition the importance on the database in requesting medical records, it is equally important on the production side. Virtually all medical records are produced in digital format. Records are typically available in PDF or TIFF file format, making them searchable by many document management systems – including on premise, cloud-based, web-based or hybrid systems. They are usually made available for download and/or viewing from virtually anywhere on any device that supports a secure micro-browser. The MRR service maintains the medical records for ongoing access by the user and any authorized personnel.

MRR Costs and other Considerations

The MRR service will charge you for their services. However, because the firm’s resources are freed up to work on activities that generate revenue for the firm, the costs of using an MRR service will be offset at least in part, and perhaps in full. In addition, depending on your fee arrangement with your client, the invoices from the MRR service may be directly billable back to the client or at least accounted for as a recoverable cost. (Many MRR services charge no monthly fees for having an account, and thus the firm only incur fees on a usage basis, which can then be charged to the cases for which they are required.)

Summary

While many firms may continue the “do-it-yourself” approach, solos and small firms should consider using an MRR service. In addition to the higher costs of installing and maintaining one’s own record management system, the soft costs and resource consumption make this a less favorable alternative. A qualified, experienced MRR service offers a cost effective, robust platform for processing, monitoring, and tracking medical records requests. Record management and processing is HIPAA-compliant, always available, and secure-which in-house processes may not be, with the attendant risks. Use of an MRR service does not require capital expense to leverage digitally filed and maintained medical records. Firm resources can be repurposed from tracking record requests to meaningful and fee-generating activities. Client satisfaction may improve as matters are able to be processed more efficiently, and firm business may increase. The results of using an MRR service are measureable and immediate. It’s literally a one-click quantum leap from manual, resource-heavy processes to a modern, digital, secure web based management for your practice.

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