|
|
|
|
ERISAclaim.com Free
ERISA Webinars
2010 Free Webinars
New Obama Health Reform Law Webinars - New
Reimbursement Laws for Claims Processing and Appeals
(Please
scroll down for the dates and registration links)
The
Latest Federal Court Overpayment Lawsuit Ruling and New Obama Health Laws
(Please scroll down for the dates and registration links)
Free Webinar Registration for Self-insured Health Plans -
Embezzlement Recovery Services (ERS) for Midsized and Large ERISA Health
Plans (New dates forthcoming)
2010 Free Webinars
ERISA Webinar Handout |
03-23-2010
New Free Obama Health Law Webinars Announced For
Healthcare Providers and Health Plans on New Reimbursement Laws for Claims
Processing and Appeals
03-23-2010, Hanover Park, IL
President Obama Signed
Into the Law the Healthcare Legislation to Revamp Healthcare Reimbursement Laws
for All Group Health Plans and Health Care Providers 03-23-2010, Hanover Park, IL
New Free Webinars Announced to Discuss the Latest
Federal Court Overpayment Lawsuit Ruling and New Obama Health Laws for the
Skyrocketing $6 Trillion Overpayment Recoupment Market 03-29-2010, Hanover Park, IL
|
New Obama Health Reform Law Webinars - New
Reimbursement Laws for Claims Processing and Appeals
ERISA Webinar Handout |
03-23-2010
Register for a
session now by clicking a date below:
Wed, Apr 21, 2010
1:00 PM - 2:00 PM CDT
Wed, May 12, 2010
1:00 PM - 2:00 PM CDT
Wed, June 09, 2010
1:00 PM - 2:00 PM CDT
The Final Health Reform Bill Has Been Signed By President Obama
Into The Law Of The Land For More Than 95% Americans, As The
Most Significant Changes Since Medicare Was Created 45 Years
Ago. What Does Obama Healthcare Law Mean To Healthcare Providers
And Health Plans? New Free Webinars From ERISAclaim.com Was
Announced To Discuss New Federal Reimbursement Law Mandates For
All Group Health Plans And Health Care Providers: ERISA Internal
And External Appeals, Extended Disclosure And Appeal Rights, New
Federal UCR Fee Centers And New Federal Simplified, Uniform
Standards For Claim Processing And Appeals.
Webinar Topics: (40 min
Presentation + 20 min Q &A)
1. Specific and accurate statutory provision reviews and
discussions on all new Obama health law mandates for claims
Processing and appeals
2. Basic Information on ERISA Claim Regulations and Current
Claims Practice
3. Please download Webinar Handout at http://www.erisaclaim.com/Free_ERISA_Webnars.htm
“After the legislation becomes the law of land for America
health care, it is time for everyone who truly cares about
reimbursement and compliance to forget about yesterday's
legislation enthusiasm, set aside personal emotions and
political preferences, to get hands on today’s new reality,
statutory and regulatory compliance and reimbursement by
learning and mastering new rule of the game for health care
reimbursement through compliance”, said Dr. Jin Zhou, president
of ERISAclaim.com.
Register for a
session now by clicking a date below:
Wed, Apr 21, 2010
1:00 PM - 2:00 PM CDT
Wed, May 12, 2010
1:00 PM - 2:00 PM CDT
Wed, June 09, 2010
1:00 PM - 2:00 PM CDT
Once registered you will receive an email confirming your
registration
with information you need to join the Webinar.
System Requirements
PC-based attendees
Required: Windows® 7,
Vista, XP, 2003
Server or 2000
Macintosh®-based attendees
Required: Mac OS® X 10.4.11 (Tiger®) or newer
|
New Free Webinars
Announced to Discuss the Latest Federal Court Overpayment
Lawsuit Ruling and New Obama Health Laws for the Skyrocketing
$6 Trillion Overpayment Recoupment Market 03-29-2010, Hanover Park, IL
The
Latest Federal Court Overpayment Lawsuit Ruling and New Obama
Health Laws
Register for a session now by clicking a date
below:
Fri, May 7, 2010 1:30 PM - 2:00 PM
CDT
Fri, Jun 4, 2010 1:30 PM - 2:00 PM
CDT
To Discuss The Latest And The First Federal Court Ruling On
March 18, 2010 That A PPO Participating Provider’s Lawsuit
Against Anthem BCBS, For The Alleged Wrongful Overpayment
Recoupment and Even Withholding From Different Patients, Is
Completely Governed By Federal Law, ERISA, Rather Than PPO
Contracts And State Laws.
New Obama Health Reform Laws That Mandate ERISA Appeals For
All Group Health Plans And Health Providers.
“It is extremely important for all health plans, TPA’s,
managed care operators and healthcare providers to comply with
governing federal laws in resolving and prevailing all
overpayment claims disputes and overpayment recoupment and
withholding,”
Register for a session now by clicking a date below:
Fri, Apr 2, 2010 1:30 PM - 2:00 PM
CDT
Fri, May 7, 2010 1:30 PM - 2:00 PM
CDT
Fri, Jun 4, 2010 1:30 PM - 2:00 PM
CDT
Once registered you will receive an email confirming your
registration
with information you need to join the Webinar.
System Requirements
PC-based attendees
Required: Windows® 7, Vista, XP, 2003 Server or 2000
Macintosh®-based attendees
Required: Mac OS® X 10.4.11 (Tiger®) or newer
|
Embezzlement Recovery Services (ERS)
for Midsized and Large ERISA Health
Plans
“Anti-fraud initiative is not
complete until and unless the recouped overpayment money originated from the
plan assets is finally returned to the original self-insured health plans,
or the fake anti-fraud crusaders are the real fraud culprit”, said Dr. Jin
Zhou, the president of ERISAclaim.com
|
Free Webinar Registration for Self-insured Health Plans
Space is limited and only open to self-insured health plans
Webinar Title:
Overpayment Recoupment Embezzlement Recovery
Reserve your free Webinar seat now at
https://www1.gotomeeting.com/register/857663256
Date:
Wednesday, December 23, 2009, Time: 12:30 PM - 1:00 PM CST
https://www1.gotomeeting.com/register/177031920
Date:
Wednesday, January 27, 2010, Time: 12:30 PM - 1:30 PM CST
https://www1.gotomeeting.com/register/514303152
Date: Monday,
February 22, 2010, Time: 12:30 PM - 1:00 PM CST
Free Overpayment Webinar Announced For
Self-insured Health Plans To Get Immediate Relief from New $1 Trillion
Overpayment Recoupment Embezzlement Market 11-23-2009, Hanover Park, IL |
2009 Free Webinars
Register for a session
now by clicking a date below:
Fri, Dec
4, 2009 1:00 PM - 2:00 PM CST
Mon, Dec
14, 2009 1:00 PM - 2:00 PM CST
All of Our ERISA Webinars
are Free and 60 Minutes for Each Session. All Time Zone Is U.S. Central
Standard Time.
Free Webinars on New Health Reform
for Healthcare Providers
-
No One Else Has Talked About How
Both House and Senate Bills Will Harm or Protect Healthcare Providers for
Their Reimbursement Rights, When Every One Is Talking About How The Health
Bills Will Be Financed;
-
Both House and Senate Bills Have
Complete Similarities On The Internal and External Appeal Laws For All
Health Plans;
-
How Healthcare Providers Will Be
Winning Or Losing Under The New U.S. Healthcare Reform Laws after 2009?
This is the only extensive
analysis on both House and Senate Bills (they happened to be same) on
Provider's Rights and our Reimbursement Rights after the New Year in the New
Obama Health Laws, when no one else in public has talked about this
most important issue for all of us: How do WE, providers, get paid or
protected.
New Health Reform
for Healthcare Providers
&
ERISA
Basics & Healthcare Claim Denial and Appeals
Register for a session
now by clicking a date below:
Fri, Dec
4, 2009 1:00 PM - 2:00 PM CST
Mon, Dec
14, 2009 1:00 PM - 2:00 PM CST
|
ERISA Basics & Healthcare
Claim Denial and Appeals
Free Webinar Topics To Be
Covered
PPT: 20 minutes, Q&A: 10
minutes = 30 minutes total |
-
New U.S.
Healthcare Reform Has Made ERISA Claim Regulation as the Claim
Regulation for All Health Plans in the Future.
-
The
Latest U.S. Supreme Court Rulings On ERISA And Healthcare:
ERISA Governs Completely (100%) Claim Dispute And Denial For
Benefits With All Employer Sponsored Plans, Both Self-Insured
And Fully-Insured, And ERISA Pre-Empts Completely (100%) Any
And All State Laws And Managed Care Contract For Claim
Benefits Dispute.
-
Federal Law, ERISA Basics,
and Your Claims
- How
To Identify ERISA Plans In 5 Seconds As Soon As Your Patients
Completely Registrations;
-
Statutory ERISA Definition On A "Denial", Any Payment Or
Overpayment Refund Less Than 100% Claimed,
-
How Can A Provider
Completely Enjoy Or Be Entitled To The Same ERISA Rights
(Verification, Direct Payment Without PPO And Appeal....) As
Your Patients Under ERISA?
- How
To Appeal Commonly Seen Healthcare Claim Denials Or Delays.
- Statutory
ERISA Definition On A "Denial", Any Payment Or Overpayment Refund
Less Than 100% Claimed,
-
Overpayment Refund Demand =
Retrospective Or Retroactive Benefits Denial = Triggers ERISA
Appeal Process For Full And Fair Reviews, "Statute Of Limitation" Or
Timeline Under Federal Law ERISA For Overpayment Denials, Burden Of
Proof And Disclosure Obligations By The Payer;
-
How To
Appeal Overpayment Refund Denials Or Demand.
- Latest
Nationwide
ERISA & RICO Class Action Lawsuits
By Providers Against Payers Over Overpayment Refund Dispute
|
Please send an E-mail to
ERISAclaim@aol.com with your name, Co. professional title and contact
info as well as the session you would like to attend, we will send you our
Free Webinar Log-in Info.
The New Healthcare Reform Bill
Passed by The Congress Prompted The New Claim Specialist Certification
Class from ERISAclaim.com
11-9-2009, Hanover Park, IL
"New Health Care Reform Bill, The
Affordable Health Care for American Act, Was Passed by the House Of
Representatives Saturday Night, and Is Expected to Be Signed into Law
by the President Obama by the End of the Year with Absolute
Confidence.
ERISAclaim.com Announced the
First Claim Specialist Certification Class Specifically for the
Compliance with the New Federal Healthcare Law for 96% of Americans"
ERISAclaim.com Is Pleased to Announce Free ERISA
Webinars for Healthcare Providers, Coding & Billings Professionals, Payers,
TPA's & MCO Professionals, and Healthcare Attorneys.
We will have in-depth discussion at
our free Webinars on why and how ERISA claim regulation will be incorporated
in it entirety into the New Obama Health Plan for All,
The Affordable Health Care for American Act, for 96% of
Americans.
##################################
ERISA,
Employee Retirement Income Security Act of 1974, is a federal law that
governs and regulates healthcare claims for estimated more than 170
million Americans who obtained health insurance or benefits from
employment in private sector, for both self-insured and fully-insured
(through purchase of insurance) health plans. ERISA law completely
(100%) preempts, supersedes and invalidates any and all state laws and
private managed-care contracts for PPOs and HMOs in any and all
dispute over denial of benefits from an ERISA plan. ERISA regulates
and governs healthcare claims which include the paid ERISA healthcare
claims in more than 50% of $2.4 trillion, 16.6% of GDP, of the
national health expenditure in 2008, and also include the denied
healthcare claims, legitimately or wrongly for appealable claims, in
more than 50% of $5 trillion in the aggregated denied healthcare
claims in 2008. More than 60-70% of healthcare claim denials from
insurance companies and managed-care third-party payers by
employer-sponsored plans are due to ERISA regulated plan or policy
coverage, limitations and exclusions rather than traditional billing,
coding, medical necessity and managed care contracting or
participation dispute. Although in the past 35 years the notices for
ERISA rights to appeal were written on almost every EOB (Explanation
of Benefits) in the daily practice in doctors' offices and hospitals,
the healthcare providers, managed-care third-party payers, and even
legal professionals as well as the state regulators rarely understood
how to conduct, manage or regulate ERISA claim appeals for ERISA claim
denials and disputes.
There have
been urgent and popular regulatory needs and market demands for ERISA
claim compliance education and training in this $6 trillion healthcare
denial management market.
Related links:
ERISAclaim.com:
ERISA or non-ERISA Appeal? ERISA Appeal Fact Sheet
ERISAclaim.com -
ERISA or PPO? Managed Care Slavery or ERISA Superhero
ERISAclaim.com -
ERISA Appeals or Lawsuit with PPO Contract or Class-Action Settlement
ERISAclaim.com:
ERISA or non-ERISA Appeal? ERISA Appeal Fact Sheet
|
| |
|
|
ERISA &
Claim Denials
|
|
Aetna Video Shows ERISA Patients Mistreated
"According to the video, when faced with claims for identical
medical problems, Aetna separates the claims where no damages
are available - those subject to the federal Employee Retirement
Income Security Act, or ERISA - from non-ERISA claims, where
consumers can sue.1 2" |
|
 |
|
ERISA &
Health Claim |
|
What Is
ERISA and How Does It Affect Patient Rights?
"ERISA was enacted in 1974 to protect the pension and welfare
benefits that employers provide their workers. It currently
covers about 2.5 million health plans and 125 million workers,
retirees, and dependents." |
|
|
|
|
$10,600 ERISA Claim
|
| Recent Federal Court Ruling in a Case with
$10,600 medical claim, insurance Co. refused to pay, provider
made numerous demand for payment in almost one year, but no
appeals filed, the court dismissed the lawsuit because provider
failed to exhaust administrative remedy, as required under ERISA,
by filing ERISAclaim appeals. This situation is so popular
in health-care community.
|
|
|
|
| |
|
|
|
|
Agree to terms and conditions
"Each
benefit plan defines which services are covered, which are
excluded, and which are subject to dollar caps or other limits.
Members and their providers will need to consult the member's
benefit plan to determine if there are any exclusions or other
benefit limitations applicable to this service or supply."
CIGNA - Coverage Positions/Criteria
"The terms of a participant's particular benefit
plan document [Group Service Agreement (GSA), Evidence of
Coverage, Certificate of Coverage,
Summary Plan Description (SPD) or similar plan
document] may differ significantly from the standard benefit
plans upon which these Coverage Positions are based.
If
these Coverage Positions are inconsistent with the terms of the
member's specific benefit plan, then the terms of the member's
specific benefit plan always control."
UnitedHealthcare Medical Policies
"By clicking "I agree," you agree to be bound by
the terms and conditions expressed below, in addition to our
Site Use Agreement.
UnitedHealthcare medical policies have been made available to
you as a general reference resource. When reading these policies
you agree that:
Our Medical Policy is not your patient's Benefit Plan.
Your patient's medical
benefits are governed and determined by a benefit document,
either a Certificate of Coverage or a
Summary Plan Description. You should not rely on
the information contained in this Web site section to determine
your patient's medical benefits.
-
Federal and state mandates and the patient’s
benefit document take precedence over these policies.
-
The patient’s benefit document lists the specific
services that have coverage limits or exclusions.
Our Medical Policy does not address every situation and
individuals should always consult their physician before making
any decisions on medical care."
|
|
 |
|
|
