PPACA Claims Specialist -- YF Corporation Makes History in Advocating Patient’s Bill Of Rights for Claims Denials

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On April 18, 2011, YF Corporation Completed the 2nd Phase of Its PPACA Claims Specialist Certification Training, Making History Under Sweeping Health Reform Law & PPACA Claims Regulations for Advocating Patient’s Bill of Rights in Claims Denials.

Becoming PPACA Claims Specialists and submitting PPACA claims appeals are the most effective strategy for overturning improper claims denials and delays.

On April 18, 2011, YF Corporation completed the 2nd phase of the nation’s first PPACA & ERISA Claims Specialist Certification Training program, in compliance with the most sweeping federal health reform law & PPACA Claims Regulations. As the first certified PPACA & ERISA Claims Specialist in the nation, YF Corporation is making history by advocating Patient’s Bill of Rights to fight against abusive and non-compliant claims denials and delays. This historical PPACA & ERISA Claims Specialist training for YF Corporation is both important and timely for the healthcare industry, as supported by the Congressional GAO report on March 16, 2011. PPACA Claims Regulations became effective on Sep. 23, 2010 and implemented the most sweeping health care reform protections in reimbursement law since the enactment of Medicare 45 years ago.

PPACA adopted federal ERISA law as the minimum “PPACA Internal Appeal Standards” for all group health plans as well as the individual policy market. PPACA Claims Regulation compliance is now a federal mandate for all healthcare providers. (http://www.dol.gov/ebsa/healthreform/)

The PPACA & ERISA Claims Specialist Certification training from ERISAclaim.com is designed to provide systematic, practical PPACA and ERISA Claims Regulations training on an expert level.

On March 16, 2011, Congress released the PPACA mandated GAO Report, indicating that only a very small portion of denied claims were actually appealed (0.5% in Ohio), but when appealed, 39 to 59% reversed the initial denials. (http://www.gao.gov/products/GAO-11-268)

“The recent Congressional GAO report clearly indicates the effectiveness of appeals. Becoming PPACA Claims Specialists and submitting PPACA claims appeals are the most effective strategy for overturning improper claims denials and delays.” said Vince Flores, Vice President of YF Corporation.

“PPACA’s claims regulations have truly become the New Patients’ Bill of Rights, which Congress has prescribed. The PPACA Claims regulations provide powerful and timely protections against all claim denials, delays and have also plugged holes left by ERISA’s Claim Regulations.” commented Mark Flores, Director, YF Corporation.

HHS, DOL & IRS: “Fact Sheet: The Affordable Care Act’s New Patient’s Bill of Rights”
(http://www.healthreform.gov/newsroom/new_patients_bill_of_rights.html)

With over 20 years of industry experience, and 10 years of ERISA practice, YF Corporation officially started its PPACA Claims Specialist Certification training in Jan 2011 and expects to complete the training by the end of the year, becoming the first PPACA & ERISA health care revenue and consulting firm in the nation to be certified as PPACA Claims Specialists.

On March 4, 2011, AMA reported that 51% of doctors in TX are in dire financial straits. According to the AMA report, “69% had cash flow problems because payments from government and private insurers arrived late, below what was billed, or not at all.” AMA - “51% of Texas doctors dug into personal funds to keep practices afloat in 2010” - “More Texas Doctors Dipping Into Personal Reserves To Keep Practices Alive” (http://www.ama-assn.org/amednews/2011/03/14/bisc0314.htm)

In January 2011, YF Corporation renewed its PPACA Mission statement for release to be as follows:

It is the official policy of YF Corporation that physician and surgeon clients be encouraged to “advocate for medically appropriate health care” for their patients. For purposes of this Policy, "to advocate for medically appropriate health care" means to appeal a payer’s decision to deny payment for a service, for maximum, legally entitled benefits reimbursement in compliance with new federal health reform law, PPACA’s New Patient’s Bill of Rights and California law, ‘Providers’ Bill Of Rights’ under California Business and Professional Code §2056 (b).”
(http://info.sen.ca.gov/cgi-bin/displaycode?section=bpc&group=02001-03000&file=2050-2079)

YF Corporation participated in the ERISAclaim.com’s PPACA & ERISA Claims Specialists Certification Training Programs, which are exclusively designed to provide expert guidance with compliance, implementation and an in depth understanding of PPACA & ERISA claims regulations:
(http://www.erisaclaim.com/certification.htm)

Complete Affordable Care Act Regulations and Guidance can be found on DOL website: http://www.dol.gov/ebsa/healthreform/

HHS, DOL & IRS News Release: “Administration Announces New Affordable Care Act Measures to Protect Consumers and Put Patients Back in Charge of Their Care” (http://www.hhs.gov/news/press/2010pres/07/20100722a.html)

HHS, DOL & IRS: “Fact Sheet: The Affordable Care Act: Protecting Consumers and Putting Patients Back in Charge of Their Care July 22, 2010 (http://www.healthcare.gov/news/factsheets/protectconsumers_factsheet072210.pdf)

Located in Los Angeles, CA, YF Corporation is a leading multi-facet healthcare solution company with dedicated appeals specialists in billing, coding, revenue recovery services, consulting, claims review and compliance. With many physicians and ambulatory surgical centers as clients statewide, YF Corporation has been fighting for the rights of consumers and providers by appealing denials, partial denials and overpayment requests, with ERISA training from ERISAclaim.com since 2001. YF Corporation offers FREE webinars to keep you updated on new Federal Court decisions, PPACA claims regulation enforcement and how these directly affect reimbursements.

For information regarding YF Corporation: http://www.YFcorporation.com

To schedule a free webinar, please contact Mark Flores, Director, at info(at)YFcorporation(dot)com or call 213-355-3900.

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