“ERISA stands for ‘Everything Ridiculous Imagined Since Adam.'”
(Florence Nightingale Nursing Serv. v. Blue Cross & Blue Shield, 832 F. Supp. 1456, 1457 (N.D. Ala. 1993).)
There is an urban legend that ERISA stands for the “Employee Retirement Income Security Act of 1974,” but is that really true? After all, we’re talking about health coverage here, not “retirement income;” And experts say that under existing federal law, there’s nothing that gives employees “security” on their health coverage.
To help healthcare providers advocate for patients under the ERISA and Patient Protection and Affordable Care Act, ERN/The National Council of Reimbursement Advocacy (ERN/NCRA) has organized a comprehensive PROFESSIONAL CLAIMS COMPLIANCE FEDERAL ACCELERATED PROGRAM that takes registrants into a one (1) day mini-boot camp on cases and laws that prohibits ERISA Plans from engaging in unfair payment patterns and claim settlement practices.
This powerful and interactive session will arm your staff how to combat Third Party Administrators that defraud or misappropriate funds for ERISA Employer Plans by:
- Underpaying out of network emergency providers.
- Failing to pay claims within statutory timeframes.
- Ignoring assignments of benefits and authorizations and making payments directly to patients and MUCH MORE!
Participants will gain indispensable insights into:
- ERISA statutory timeframes for reimbursement.
- Standing as a Provider or Authorized Representative of the patient.
- How to have assignable benefit checks reissued and redirected to your provider.
- The relevance of an authorization and implied contract.
- How to demand UCR methodology for underpaid claims and get reimbursed higher as an out of network provider.
- How to challenge inappropriate utilization reviews and medical necessity denials.
Are you distinguishable in your workplace or industry?
As a health care financial professional and advocates for medically appropriate healthcare, you cannot afford to define normal by what the rest of the industry considers common payor behavior.
NOW you can distinguish yourself with mastery of administrative laws that govern the healthcare delivery
system and get the resources, training and legal muscle to aggressively challenge unfair payment practices!
For one low price—just $349.00 per person—you’ll get: 1.) Hundreds of pages of informational and practical instructional materials 2.) Sample Letters, Affidavits and Case Study Examples and 3.) Denial Simulation Exercises.
Minimum of 10 attendees required.