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
Hanover Park, IL (PRWEB) February 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.