The New Hospital ERISA Appeals Department Program Announced for Hospital In-House Denial Management and Financial Crisis Turnaround

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For The First Time In U.S. Health Care History, Announced The Nation's First Hospital ERISA Appeal Department Program To Provide Hospital With A Turn-Key Set-Up Training For The In-House ERISA Appeals Department To Combat Commercial Managed Care Denials, Overpayment Recoupment Crisis, And Revenue Cycle Outsourcing Dilemmas For Hospital Survival, And ERISA Compliance, In Wake Of The Latest AHA Report Of More Than $36 Billion Hospital Uncompensated Care Cost

the Godfather of ERISA Claims announced nation's first Hospital ERISA Appeals Department Training Program to provide 5,815 hospitals with real emergency resuscitations in revenue cycle, in the wake of latest Nov. 2009 American Hospital Association Report that uncompensated hospital care costs reached more than $36 billions in 2008, and more than 60% of the hospitals lose money providing patient care and one-third lose money overall. In 2010, all hospitals are facing Medicare payment cuts, unconscionable managed-care contracting with poor reimbursement, and more uninsured care costs as well as endless alleged overpayment refunds withholdings and Medicare RAC paybacks.'s Hospital ERISA Appeals Department Training Program is a turn-key emergency resuscitation service for all hospitals to set up an ERISA fully compliant Appeals Department, with on-site training of in-house Certified ERISA Claim Specialists, without any traveling for hospital staff, enhanced with short and long term live support from for hospital commercial and managed care 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 recovered hospital claims.

ERISA, Employee Retirement and Income Security Act of 1974, is a federal law, enacted by Congress in 1974. ERISA Appeals Practice are statutory and regulatory for denied ERISA claims for 80-90% of non-Medicare and Medicaid claims for about 170 million Americans, governing both self-insured and fully-insured health plans, said Dr. Jin Zhou, the President of, a national leading expert in ERISA Appeals.

ERISA is the only federal law for 35 years, governing hospital revenue cycle and financial incomes from commercial employment based hospital 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. Among 5,815 registered hospitals in the U.S., there has not been a single one hospital with fully compliant ERISA Appeals Department, even after the ERISA appeals and compliance warnings were given to the hospitals for 35 years on every insurance claim denial EOB (Explanation Of Benefits), in every managed care contract and insurance company's Medical Policy, in every class action settlement agreement and every federal court ruling for ERISA claim disputes, especially a unanimous U.S. Supreme court. More than 80-90 percent of non-Medicare and Medicaid claims are ERISA claims in USA.

"It doesn't take a hospital CFO or biller to ask Albert Einstein if a hospital should do ERISA appeals, when ERISA appeals are mandatory under the federal laws for 35 years and every EOB of denied claims has given you 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 get paid by an ERISA plan, according to U.S. Supreme Court in Aetna v. Davila in 2004. No one needs to ask around if a hospital 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, hospital industry has never paid correct and serious attentions to or take any proper actions to understand this 7-page federal law while going through bankruptcies for some, and writing off tens of billions of dollars of ERISA claim denials in the more than $36 billion uncompensated hospital care costs for 60% of 5,815 hospitals, as reported by AHA in Nov. 2009.

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 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 hospital must take immediate actions in established ERISA appeals process for 35 years to secure a hospital's financial survival, as advised by Dr. Zhou.'s Hospital 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. also provides ERISA Claim Specialist Certification Training Classes for non-institutional providers in major U.S. cities.

In the past 10 years in USA, 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 has been referred to as "the Godfather of ERISA Claims" for providers in the healthcare industry. is dedicated to helping hospitals 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 hospitals and prevent working American family from bankruptcies as a result of unpaid medical bills, and to minimize revenue cycle outsourcing dilemmas for hospitals already in financial respiratory failures.

For more information, please visit, or contact Dr. Jin Zhou, president of, at 630-808-7237.


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