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U.S. Healthcare Crisis Turnaround?

U.S. A.

Drs. & Hospitals Employers

$1.0 Trillion / Year

$$$ ERISA $$$

50% Savings

The Only Company with Compliant Solutions for All of You

Rx-1  $$$$$$$$$ERISA"Health Insurance Challenges: Buyer Beware" 3-3-04
Hearing, Senate Committee on Finance
$$$$$$$$$$  Rx-2
US Supreme Court Visits ERISAclaim.com

at 11:57:03 AM on Friday, November 21, 2003

ERISA Failure Syndrome

U.S. Healthcare Crisis Trilogy

(Copyright © 2004 by Jin Zhou,  ERISAclaim.com)

 

ERISA
Medical Killing
ERISA
Medical Inflation
ERISA
Insurance Robbery
"Health Insurance Challenges: Buyer Beware" 3-3-04
Hearing, Senate Committee on Finance

Read Making a Killing

?

 

?

Bar graph showing trends in hospital charges and revenues in California from 1995-2002

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GAO-04-312

?
 

?

American Job ExportING!

Mass layoffs up in January 2004

Weirton Steel cancels 10,000

GM: $67.5 billion in 2003

One Nation under Debt: U..S. economy threatened by aging of America

 

Healthcare Disaster at Fault Verdict Index:

U.S. Government 30%

U.S. Employers & Insurers 30%

Healthcare Providers 30%

Consumers 10%

(ERISA Failure + Managed-Care) Destroyed US Healthcare
(ERISA Failure + Managed-Care + HSA) Invite US Federal Budget Deficit & Social Security Disasters = 100X 9/11 Attacks

 

GAO: Current and Emerging Fiscal and Retirement Security Challenges, American Benefits Council/MetLife Conference, Washington, DC, on January 14, 2005

  1. Rising Health care Costs Have Many Implications (Direct)

  2. Rising Healthcare Costs Have Many Implications (Indirect)

 

Rx-1  $$$$$$$$$ERISA"Health Insurance Challenges: Buyer Beware" 3-3-04
Hearing, Senate Committee on Finance
$$$$$$$$$$  Rx-2

 

 

About Us

 

ERISAclaim.com is a new provider of services concentrating uniquely on solving U.S. health care crisis, improving healthcare ERISA claim administration with regard to claim denials and appeals through ERISA compliance and education. We, with the principal and founder, Dr. Jin Zhou, are committed to providing unique and practical solutions to our nation's health care crisis, in case the Congress and the President of the United States fail to stop our health-care crisis and probable health care crash.

 

As nation's only ERISA concentrated claim denial and appeal compliance solution firm, we provide and deliver demystified and practical ERISA solutions where entire nation has failed in the past 28 years and when this nation is facing the worst healthcare crisis!

 

We will provide educational and consulting solutions to healthcare providers, clinics and hospitals for maximum reimbursement or crisis turnaround only through compliance of ERISA.

We will provide educational and consulting solutions to employers/plan sponsors, insurers and TPA's with compliance assistance to minimize administrative costs and risks through compliance of ERISA.

 

We will provide educational and consulting solutions to the nation to establish or restore the hope, faith and the Law & Order  for our health-care system through education and compliance of ERISA, the federal law designed to regulate about 80% of the health-care claims and 60% of the U.S. health-care expenditure, ERISA is the only "nuclear power" capable of stopping our escalating health-care costs. Compliance is the only common ground for everyone, and it is the only way that we can bail out of our worst health-care crisis since World War II.

 

We are located in northwestern suburb of Chicago, IL. We provide unconventional but practical solutions to our nation's health-care crisis. We work with health-care providers, employers, insurers, TPA's and regulators on the common ground of compliance of the ERISA. We believe existing ERISA is the only "nuclear power" that is capable of stopping our escalating health-care costs and uncontrollable health-care premium, the compliance of ERISA is only common ground for everyone in our economy and labor force as well as health-care industry. We are available for consulting, seminar, and executive brainstorming under the principle of compliance and solutions.

 

 

About Dr. Jin Zhou

 

Dr. Jin Zhou is a national speaker, consultant, author and publisher of health-care ERISA claim denials & appeals, regulation education and compliance. He pioneered, authored and published the nation's first ERISA Health-care Claim Appeal System in a CD book, and the nation's first website (www.ERISAclaim.com) in ERISA healthcare claim denials, appeals, claim regulation education and compliance, “ERISAclaim.com”.

 

He has taught ERISA seminars across the country in past 5 years to health-care providers, hospitals, billing and coding professionals, and managed-care organizations.  Dr. Zhou’s articles and expert advice were quoted and appeared on numerous industry professional magazines, web sites and organizations.  Dr. Jin Zhou was an orthopedic surgeon with Air Force General Hospital in China prior coming to United States in 1988. He is a licensed chiropractic physician in Illinois since 1991. In addition to his ERISA compliance and educational practice, he maintains an active clinical practice in Chicago suburb in Illinois. Dr. Zhou has been actively participating in teaching and innovative clinical research in medical science (www.SleepApneaUSA.net).

 

 

The Root of U. S. Healthcare Crisis

Jin Zhou, ERISAclaim.com

The Hearing at Senate Committee on Finance on 3-3-04, [View Video "Health Insurance Challenges: Buyer Beware" 3-3-04
Hearing, Senate Committee on Finance
or Transcript (PDF) (KaiserNetwork.org)]  revealed the mechanism, nature and extent of ERISA failure and nonenforcement as the reasons for "Growth in Bogus Health Insurance Plans Targeting Desperate Small Business Owners", as being concluded as "No the results are not good. It’s a tragedy." by Ann Combs, assistant secretary of DOL. The mechanism, nature and extent of ERISA failure and nonenforcement as presented at the Hearing are universally true and applicable to all health care claim denials and delays in managed care environment from all employer sponsored health plans as the root of U. S. healthcare crisis.

 

This is a 911 call on "healthcare 9/11 disaster"!

THE 9/11 COMMISSION REPORT (pdf)

 

Fraud Health Care Cards
"New Strike Force"

Medical Fraud Every Day?

Appeal or Re-Bill After Denial?

You Must APPEAL

No Re-Billing!!!

Claim Appeal or Sentencing Appeal?

Your Choice
Maximal Reimbursement
through ERISA Appeal &

Fraud Prevention and Compliance

 

 

e-mail us for more information

 

Legal Disclaimer

    The publication or information on this Website is designed to provide accurate and authoritative information in regard to the subject matter covered. It is presented and published with the understanding that the author and publisher are not engaged in rendering legal, accounting or other professional service or advice. If legal advice or other expert assistance is required, the services of a competent professional person should be sought.

 

    We're not employees of, or in affiliation with any governmental or regulatory agencies.

 

    ERISAclaim.com is not a law firm. We do not practice law. If legal action or advice is required to successfully resolve a claim or a claim/business decision, we will refer out our client to an outside legal counsel chosen by our client.

 

    We do not teach, advise or participate in coding & billing of your health care claims and practice.  We advocate  appeals of your already denied claims through compliance and compliant claim processing for savings in accordance with ERISA claim regulations and applicable federal and state laws.

 

    Although ERISAclaim.com often works in conjunction with, but completely independent from, different law firms or seminar sponsors whose practice is focused on the representation of or advising clients in health care ERISA claims dispute or compliance, those  law firms  or companies advertising on ERISAclaim.com are not affiliated with or employed by or with ERISAclaim.com. ERISAclaim.com disclaims any and all responsibility or liability for the accuracy, content, completeness, legality, reliability, or operability or availability of information or material displayed or advertised on the ERISAclaim.com ERISAclaim.com disclaims any responsibility for any harm resulting from downloading or accessing any information or material on the Internet linked to or through the ERISAclaim.com.
 

    Except for otherwise specifically stated, our educational and training for certification programs are not affiliated with any governmental or educational institute for the purpose of  accreditations or degrees. Our certifications are only for attendance in studying subject materials specified in each individual programs for advancing educational knowledge with respect to applicable business and  compliance.

 

ERISAclaim.com

Happy
Birthday Sept. 2,
1974
30th
Birthday

 

Happy or Sad 30th Birthday To ERISA?

(Copyright © 2004 by Jin Zhou,  ERISAclaim.com)

Sept. 2, 2004

On Sept. 2, 1974, exactly 30 years ago today, ERISA, The Employee Retirement Income Security Act, was signed into law by President Gerald R. Ford. The congressional intent in enacting ERISA was to protect employees in pension and welfare plans, to provide uniform federal protections in response to the failure of the Studebaker Co. in December 1963, with thousands of long-service employees cheated out off their promised pensions, and to preempt any state laws when the employees pension and welfare benefits were threatened. 30 years later, ERISA Failure in its compliance and enforcement left thousands of retirees without medical benefits, and resulted in a skyrocketing national healthcare expenditure explosion with 45 million uninsured and a possible national pension bailout.

ERISA Failure Syndrome

U.S. Healthcare Crisis Trilogy

 

Jin Zhou Identifies "ERISA Failure" That Killed U.S. Healthcare

"Failure of Imagination" Again?

 

 

 

 

ERISA Celebrates 30th Anniversary As Trouble Brews For the Pension Insurance Program (Spencer Benefits Reports)

Excerpt: "The seed for ERISA was planted with the failure of the Studebaker Company in December 1963, leaving thousands of long-service employees without their promised pensions."

 

 

ERISA Power Guides
(
by ERISAclaim.com, Copyright © 2004)

What You Should Know about Filing
Your Health Benefits Claim (Claims Card)

Filing A Claim For Your Health Or Disability Benefits (PDF)

Patient's Rights Claims Procedure Regulation (Fact Sheet)
Benefit Claims Procedure Regulation (FAQ)
New Federal Claim Regulation (Final Rule)
Amendments to Summary Plan Description Regulations (Final Rule)
   

New & Interactive From DOL
New @ elaws

Health Benefits Advisor

DOL/EBSA Organization Chart/Regional and District EBSA Offices | By Topic | By Audience | By Organization | By Location  

 

Health Benefits Laws By State
(Interactive Tools From Insure.com)

Health Insurance Mandates in the States, 2004: a State-by-State Breakdown ... (PDF)
(Council for Affordable Health Insurance)

Kaiser statehealthfacts.org

Consumer Guides for Health Insurance in Every State and the District of Columbia (Georgetown University)

View a 5-minute clip

Paper Chase "Health Insurance Challenges: Buyer Beware" 3-3-04
Hearing, Senate Committee on Finance

ERISAclaim.com - U.S. Health-care Crisis
& ERISA Criminal Enforcement

To Avoid "John Q.
ERISA
Enforcement"

Denials + Recoupment = Inflation + Fraud or Cost-Sharing?

Rx = Compliant Denial & Appeals!

Forbes.com: "Roughly one in seven Americans has no health insurance. That hurts HCA Inc. (nyse: HCA - news - people), the largest U.S. hospital chain, which last year wrote off $2.21 billion of revenue because patients couldn't pay their bills."

The American Hospital Association (AHA): "Hospitals today are faced with the challenge of managing their limited resources, while continuing to deliver the highest standard of care. According to health care experts, the cost of clinical denials to individual healthcare organizations averages $3.3 million annually. However, many hospitals do not have the resources or the expertise needed to avoid unpaid days at the end of admissions and lead the denial-appeals processes."

Payments Go Under a Microscope (washingtonpost.com) "MAMSI and CareFirst recoup overpayments to doctors by making deductions from future reimbursements. Doctors can appeal insurers' decisions. But, in the end, they usually pay up, doctors and insurers agree."

Hospital Pricing and the Uninsured, Glenn Melnick, Ph.D., "Price Gouging"
(Subcommittee on Health
Hearing on the Uninsured, Tuesday, March 09, 2004)

U.S. FILES COMPLAINT AGAINST NATIONAL ACCOUNTING FIRM UNDER FALSE CLAIMS ACT (DOJ Press Release"January 5, 2004 - PHILADELPHIA – United States Attorney Patrick L. Meehan announced today the filing of the Government's complaint against national accounting firm Ernst & Young. According to the complaint, nine hospitals paid Ernst & Young for billing advice – advice which later caused the submission of false claims to the Medicare program."<