ADVISORY NOTICE: AUTHORIZATION REQUESTS FOR POST-STABILIZATION CARE
July 2, 2024 9:00 amDear Provider Members, Our office has been actively pursuing the resolution of claims on your behalf for post-stabilization care and... View Article
Press Releases
APL 24-012 – Single Point of Contact for Hospitals to Request Authorization for Poststabilization Care
July 2, 2024 9:00 amFROM THE OFFICE OF THE CALIFORNIA DEPARTMENT OF MANAGED HEALTH CARE: ALL PLAN LETTER DATE: June 25, 2024 TO: All... View Article
Letter to the OIG on “Non-Interference” Policy
January 31, 2024 9:00 amEsteemed Provider Members, Here at ERN/TRAF, we advocate every day for you, your providers, and patients. Our advocacy takes many... View Article
DHMC Advises Requirements for Requesting Authorization for Post-Stabilization Care
October 25, 2023 12:00 pmDear Provider Members, Our office has been actively pursuing the resolution of claims on your behalf for post-stabilization care we... View Article
Obtaining Authorization While Patient Is In House
June 29, 2022 4:52 pmMYTH: MA Plans are not required to respond to an inpatient authorization request. FACT: MA Plans ARE required to respond to an inpatient authorization... View Article
Community Rallies Around Yorba Linda Teen in Need of Operation
April 6, 2019 5:57 pmERN in the news! This morning, I saw this piece aired by Channel 5 of a young boy we successfully... View Article
How to Challenge Improper Denials of Emergency and Post-Stabilization Services
December 4, 2018 11:00 amINTRODUCTION As a provider in the acute medical setting, you have undoubtedly experienced the difficulty in obtaining prompt reimbursement for... View Article
Can an HMO make a medical decision without looking at medical records?
February 27, 2018 10:31 amSometimes you are the only thing that stands between the single crushing blow of HMO and a patient or provider.... View Article
24 Hour UM Access
December 8, 2017 12:14 am“Hello, you have reached the UM Department. We are open Monday through Friday, 8 a.m. to 5 p.m. Please leave... View Article
CalPERS DENIES AUTHORIZED MEDICAL CARE FOR DECEASED MEMBER
September 23, 2016 9:54 am“Justice will not be served until those who are unaffected are as outraged as those who are.” – Benjamin Franklin... View Article