ERISAclaim.com Press Release
FOR
IMMEDIATE RELEASE:
The New TPA ERISA
Appeals Department Training Program Announced for Self-Insured Health
Plan’s Denial and Appeal Management To Compliantly Contain
Administrative Costs
02-11-2010, Hanover Park, IL
For The First Time In U.S. Health Care
History, ERISAclaim.com Announced The Nation’s First TPA ERISA Appeal
Management Department Program To Provide TPA’s and Self-Insured Health
Plans With A Turn-Key Set-Up Training For The In-House ERISA Appeals
Management Department To Process ERISA Appeals Compliantly to Contain
Administrative Costs and Avoid Unnecessary Litigations, In Wake Of The
New Pending Obama Health Reform Laws Mandating ERISA Compliance for
All Group Health Plans Within Six Months of The Enactment
Hanover Park, IL (PRWEB) Feb. 11, 2010 –
ERISAclaim.com announced nation’s first ERISA Appeals Management
Department Training Program to provide more than 6 million ERISA plans
with comprehensive and systematic problem-oriented ERISA Compliant
Appeal Program to combat more than 20% of the annual administrative
costs for more than 150 – 170 million working Americans and their
families with employment based health Insurance. More than 55% of
people with employment based health insurance are covered from
Self-Insured plans. Private sectors paid more than 50% of the $2.5
trillion U.S. healthcare expenditures.
ERISAclaim.com’s TPA ERISA Appeals
Management Training Program is a turn-key emergency resuscitation
service for all self-insured health plans and TPA’s to set up an ERISA
fully compliant Appeals Processing Department, with on-site training
of in-house Certified ERISA Claim Specialists, without any traveling
for plan or TPA staff, enhanced with short and long term live support
from ERISAclaim.com for all ERISA claims denials and appeals process.
The ERISA Appeals Department Setup process can be started in weeks and
completed in about 30 days, at a price of even one of correctly
managed denied claims.
ERISA, Employee Retirement and Income
Security Act of 1974, is a federal law, enacted by Congress in 1974.
ERISA Denial and Appeals are statutory and regulatory for denied ERISA
claims for 80-90% of non-Medicare and Medicaid claims for about 150 -
170 million Americans, governing both self-insured and fully-insured
health plans, said Dr. Jin Zhou, the President of ERISAclaim.com, a
national leading expert in ERISA Appeals.
ERISA is the only federal law for 35
years, governing claim processing, denial and appeals for employment
based health claims, according to a unanimous U.S. Supreme Court in
Aetna v. Davila. All state laws and managed care contracts are
completely pre-empted by federal law ERISA if impermissibly connected
ERISA plans. For more than 6 million ERISA plans, self-insured large
employer health plans, such as GM with $5.6 billion health expenses,
paid out most of the healthcare costs despite of managed care industry
practice. More than 90% of ERISA plans are lack of ERISA compliance,
with resulted double digit increase in premiums and sky-rocketing
healthcare costs after the decades of failure for managed care model
to contain the costs. With pending Obama Health Reform mandating ERISA
compliance within six months and anti-trust exemption repeal after the
enactment, ERISA compliance for all ERISA group health plans is
inevitable and mandatory.
“It doesn’t take a plan administrator or
TPA to ask Albert Einstein if an ERISA plan should do ERISA appeals
compliance and problem-oriented management, when ERISA appeals are
mandatory under the federal laws for 35 years and every EOB of denied
claims has informed every patient and provider of their ERISA
Miranda’s Right to appeal at bottom or back page of the EOB’s”,
according to Dr. Zhou.
“If ERISA Appeal is statutory and
regulatory, it is a mandate for any one who wanted to cut a plan
wastes and costs by an ERISA plan, according to U.S. Supreme Court in
Aetna v. Davila in 2004. No one needs to ask around if an ERISA plan
should do ERISA as a personal choice when ERISA is a federal law
mandate”, as explained by Dr. Zhou.
Dr. Zhou also reiterated that ERISA claim
regulation is only 7-page long in the Federal Register, for 35 years,
while contained on every denial notice for ERISA appeals, more than
90% TPA’s or plan administrators have no clue, for 35 years, on how to
process ERISA appeals in accordance with ERISA claim regulations in an
industry of $2.5 trillion healthcare costs annually.
In recent Obama Healthcare Reform
legislation, both House and Senate Bills have adopted ERISA claim
regulation, in its entirety, the 35 year old ERISA law and the
“established process”, for about 150 - 170 million Americans with
employment based health insurance, as the new mandate for all group
health plans for proposed new universal health care for additional 30
million uninsured Americans. Regardless of any passing of Healthcare
Reform Bills, every existing ERISA plan must take immediate actions in
established ERISA appeals process for 35 years to process ERISA
appeals from providers and patients, as advised by Dr. Zhou.
Only when all ERISA plans and providers
as well as patients are doing ERISA compliance in health care claim
administration and processing, health care costs will be truly under
control, as concluded by Dr. Jin Zhou.
ERISAclaim.com’s TPA ERISA Appeals
Department program starts at $50,000 for up to 5 ERISA Claim
Specialists Certification training and 30-day live phone and Webinar
supports. Each additional ERISA Claim Specialist costs additional
$8,500. An additional six-month support starts at $50,000 and one-year
support at $100,000 for ERISA Appeals Department with trained ERISA
Claim Specialists.
ERISAclaim.com also provides ERISA Claim
Specialist Certification Training Classes for non-institutional
providers in major U.S. cities.
In the past 10 years in USA,
ERISAclaim.com has been the only ERISA Specialized Company offering
the most practical and comprehensive ERISA education, consulting and
publishing services for healthcare providers in administrative ERISA
appeals for real problem oriented denials under the most mysterious
35-year-old federal law, ERISA. Dr. Jin Zhou, the president of
ERISAclaim.com has been referred to as “the Godfather of ERISA Claims”
for providers in the healthcare industry.
ERISAclaim.com is dedicated to helping
ERISA plans with compliant ERISA appeals to get paid legally, for what
the working class Americans and their families are legally entitled to
under federal law ERISA and health plan provisions, to eliminate
billions of dollars in uncompensated care costs for ERISA plans and
prevent working American family from bankruptcies as a result of
unpaid medical bills, and to minimize revenue cycle outsourcing
dilemmas for ERISA plans already in financial respiratory failures.
For more information, please visit
http://www.erisaclaim.com/Appeal_Department.htm, or contact Dr. Jin
Zhou, president of ERISAclaim.com, at 630-808-7237.
###
Contract:
Jin Zhou,
President
ERISAclaim.com
Tel:
630-808-7237 (Mobile)
Tel:
630-736-2974 (Office)
Fax:
630-736-1439
E-mail:
ERISAclaim@aol.com
website:
http://www.ERISAclaim.com
Related Links:
ERISAclaim.com: 50% Savings - Healthcare Crisis
Turnaround for Employers, Insurers & TPA's
ERISAclaim.com - A $1.0 Trillion Nuclear Solution
to U.S. Health-care Crisis & $44 Trillion Budget Deficits
American Benefits Council:
News Room - Supreme Court Ruling on Health Care Claims Raises Important
Policy Issues: American Benefits Council. June 21, 2004
"Sadly
and predictably trial attorneys and their allies are already calling on
Congress to unravel today’s decision by the Supreme Court, but they should
first ask why the two physicians in these cases did not act swiftly to help
make sure their patients got the care they were seeking.
In neither
case did the patient or their physician seek a further review of the health
plan’s initial coverage decision, despite being specifically informed of
their right to such a review under federal law."
Klein said."
"These
review procedures are available under ERISA
to help patients get the care they deserve, quickly and without having to
resort to costly and lengthy legal procedures. Clearly, a speedy and factual
review aided by the expertise of the physicians
involved with
these two cases could have avoided the need for the courts to be involved at
all,"
Klein said."
# # #
The American Benefits Council is the national
trade association for companies concerned about federal legislation
and regulations affecting all aspects of the employee benefits system.
The Council's members
