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New Federal Health Claims & Appeals Laws
&
Regulations
for 193 Million Americans
Effective 09-23-2010
©2010, Jin
Zhou, ERISAclaim.com |
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President
Obama Signing Health Bill on
03/23/2010
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President
Gerald R. Ford Signing ERISA on 09/02/1974 |
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New Webinars,
Seminars & Certification Classes Announced for New Federal Health
Claim Appeals Regulations on July 22, 2010 from HHS, DOL & IRS,
Effective On Sept. 23, 2010 for 193 Million Americans |
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UNITED STATES
DEPARTMENT OF LABOR
(Links to DOL)
©2010, Jin Zhou, ERISAclaim.com |
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Statutory Laws [PDF]
[PDF]
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Employee Retirement Income Security Act — ERISA |
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Webinars,
Seminars & Certification Classes for New Federal Health Claim Appeals
Regulations
ERISAclaim.com
- Free Webinars - New Federal Claims & Appeals Regulations, Effective
Sept. 23, 2010, for 193 Million Americans
ERISAclaim.com: Seminars - 2010 Two-day
Basic ERISA Appeal Seminars - Denials and Overpayment Appeals
ERISAclaim.com - 2010
PPACA & ERISA Claim
Specialist Certification Programs in Chicago, Illinois
ERISAclaim.com: Create An Appeal
Department for Your Hospital or Practice
(In-house, onsite ERISA Claim Specialist Certification Programs)
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03/23/2010
Breaking News
President Obama Signed Into the Law the Healthcare
Legislation to Revamp Healthcare Reimbursement Laws for All Group Health
Plans and Health Care Providers
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? The New Federal Reimbursement Laws Protect Health Care
Providers with 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. The New
Federal Reimbursement Laws Will Eventually Eliminate Most Managed care
Abuses
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Medicare CD-Book - $250
(April-May Special Discount $50)
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Click Here or the CD-Picture
to Enter
Our Secured Online Order page
Fax Order Form (Click Here)
Click Here to Download a Sample with
Complete Table of Contents in Bookmark
(pdf 1,095kb)
(Turn on Bookmarks to view Table of
Contents)
While this CD book
uses chiropractic specialty and Illinois as an example to illustrate
Medicare coding and documentation, and it's impossible to describe
every specialty and state local rules in a single book, this CD book
has provided you with very specific hyperlinks to CMS/Medicare
Medlearn provider specific materials in the beginning of the CD book
and, in the end, a complete enclosure with all PDF files from CMS
website for "Reference: Medicare Learning Network Products Catalog.
This catalog provides a list of all available Medicare Learning
Network products and a description of each product."
With a
complete reference guide with all pdf files downloaded from CMS and
hyperlinks to provider specific Information, this CD book shall be an
extreme valuable learning and practical reference tool for every
specialty and location.
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1.
How to establish medical
necessity through correct coding and documentation for expanded
coverage under New Medicare guidelines, national and local policies;
2.
How to document medical
necessity in accordance with Medicare Evaluation and Management
Documentation Guidelines from CMS and WPS official publications;
3.
How to prove medical necessity
by appropriately ordering diagnostic tests, such as MRI, or CT scans,
in accordance with local Medicare LCD to support medical necessity
beyond manual palpation and x-rays;
4.
How to obtain, understand and
implement CMS “1997 Documentation Guidelines for Evaluation and
Management Services”;
5.
How to obtain, understand and
benefit from WPS publication: “Evaluation and Management Guidebook”;
6.
How to understand CMS/Medicare
initiatives in “Fighting Fraud & Abuse” by enjoying expanded coverage
through medically appropriate medical care and documentation without
“analysis and paralysis” avoidance of Medicare new chiropractic demo
practice;
7.
How to truly understand National
Correct Coding Initiative (NCCI) to avoid fraud and abuse with
official CMS publications in presentation and reference guide;
8.
How to understand WPS Medicare
Part B - Illinois Policy on “Magnetic Resonance Imaging”;
9.
Most importantly, learn how to
obtain through Internet, understand and educate yourself for all of
these through official publications from CMS and WPS;
You shall always guide your practice based on the applicable
official CMS publications with precise and correct understanding of
subject matter. We will teach you how to search, download and
understand all of these publications and specific guidelines from CMS
and WPS. |
PLACING AN ORDER
How to order
To order our products or register for
seminar please follow the step by step process ....
Payment method
We accept personal and business checks, major Credit Cards including Visa, Mastercard,
Discover, And American Express.
Refunds Policy
Unfortunately, due to the nature of our product on CD ROM, and on-line
availability of a free
downloadable Demo version of ERISA for
Physicians: Healthcare ERISA Claims Denials and Appeals,
All orders are final with no returns and no refunds, except for
replacement due to CD disk defect.
Click here to enter our secured online order page
Fax Order Form (click here)
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$10,600 ERISA Claim
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| 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.
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$37,350 ERISA Claim
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| Health-care provider alleged medical claims
submitted to Aetna for reimbursement, Aetna asserted no receipt
of medical claims, no written denials. Health-care
provider failed to present proof of claim submission, claim
denial and ERISA claim appeals. This case was dismissed. ERISA
health-care claims are handled in federal court, state law is
generally not applicable.
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