PPACA clams regulations are just like Medicare claims regulations, but PPACA governs more money than Medicare in claims for most providers and hospitals.
Hanover Park, IL (PRWEB) February 06, 2012
ERISAclaim.com announces new strategic partnership programs on certified PPACA & ERISA Claim Specialists training for provider and hospital organizations & associations, in preparation for the Supreme Court PPACA hearing in next month & the expected final decision in June or July 2012. The new federal PPACA claims regulations have been enforced since 09/23/2010. PPACA adopts federal ERISA claim regulation entirely. The new PPACA training partnership programs will create new strategic networks with any willing provider or hospital organizations or associations to train more certified PAPCA & ERISA Claim Specialists, in compliance with PPACA & ERISA claims regulations, relying upon the Supreme Court final decision on PPACA in less than 6 months.
ERISAclaim.com predicts that PPACA claims regulations will be definitely upheld regardless what the Supreme Court may decide on the individual mandate and Medicaid expansion challenges. PPACA claims regulations are the same as Medicare claim regulations, as the Medicare program was created by the Congress 45 years ago. To be certified for Medicare claims specialists are the industry standards for decades, the same is true today for PPACA & ERISA claims, for those who like to be the first one, rather the last one, in compliance with PPACA claims regulations in the healthcare claim reimbursement and revenue cycle practice.
“PPACA clams regulations are just like Medicare claims regulations, but PPACA governs more money than Medicare in claims for most providers and hospitals, so we must be certified for both PPACA and Medicare claim specialists,” says Dr. Jin Zhou, President of ERISAclaim.com, a national expert on PPACA and ERISA appeals and compliance.
The new PPACA training partnership programs will offer important and timely reviews and services to:
1. Provide leadership and organizational guides on the Supreme Court hearing on PPACA next month;
2. Demystify the forthcoming Supreme Court final decision on PPACA in June or July 2012 for healthcare providers with respect to the PPACA Providers’ Bill of Rights in healthcare reimbursement;
3. PPACA Claims Regulations and Guidance from DOL: http://www.dol.gov/ebsa/healthreform/
4. PPACA & ERISA Claims Regulations Assistance and Complaints Webpage from DOL: https://www.askebsa.dol.gov/WebIntake/Home.aspx?submit=Submit+a+Complaint
5. PPACA Claims Regulations and Guidance from HHS: http://www.healthcare.gov/law/features/rights/bill-of-rights/index.html
6. Create partnership networks nationwide to immediately start basic and advanced training on PPACA & ERISA claims regulations for your organization or associations, as you did for Medicare claims regulations, as you will have no choice or excuses after the Supreme Court decision in 6 months;
7. Create partnership networks nationwide to immediately offer Certified PPACA & ERISA Claim Specialist Programs, as you did for Medicare claims and compliance for 45 years;
8. Create awareness and readiness to develop a national network or association for PPACA & ERISA Claim Specialists.
According to the U.S. Supreme Court’s Website, PPACA hearing is scheduled for March 27-28, 2012. A decision is expected as early as June or July 2012. The high Court will decide on whether the PPACA’s individual mandate and Medicaid expansion will be constitutional, and if unconstitutional, whether they are severable from the entire PPACA. The high Court will likely decide (1) to uphold entire PPACA, or (2) throw out the entire PPACA or (3) throw out individual mandate and/or Medicare expansion. To follow-up this important Supreme Court activities, please visit Supreme Court website:
(Patient Protection & Affordable Care Act) from several appellate cases: National Federation of Independent Business v. Sebelius (No. 11-393), U.S. Department of Health and Human Services v. Florida (No. 11-398) and Florida v. Department of Health and Human Services (No. 11-400).
Regardless what the Supreme Court may rule, the PPACA & ERISA claims regulations will stay:
1. If PPACA upheld entirely: ERISA and PPACA claims regulations will regulate both ERISA and non-ERISA group health plans, governmental or individual market, and additional 30 million Americans will be insured under PPACA Exchange & Medicaid Expansion programs;
2. If PPACA thrown out entirely: ERISA claims regulation will continue to regulate ERISA claims for 170 -180 million Americans under employer-sponsored health plans, as in the past 36 years;
3. If only individual mandate/or Medicaid expansion thrown out entirely: ERISA & PPACA claims regulations will regulate both ERISA and non-ERISA group health plans, governmental or individual market, and no additional 30 million Americans will be insured under PPACA exchange or Medicaid expansion programs.
The Congress concluded in U.S. GAO Report, (GAO-11-268 March 16, 2011): (http://www.gao.gov/products/GAO-11-268)
“Further, the data GAO reviewed indicated that coverage denials, if appealed, were frequently reversed in the consumer's favor. For example, data from four of the six states on the outcomes of appeals filed with insurers indicated that 39 percent to 59 percent of appeals resulted in the insurer reversing its original coverage denial……Ohio data indicated that 0.5 percent of claim denials were internally appealed.”
To find out more about PPACA Claims and Appeals Compliance Services from ERISAclaim.com:
Located in a Chicago suburb in Illinois, for over 12 years, ERISAclaim.com is the only ERISA & PPACA consulting, publishing and website resource for healthcare providers in the country. ERISAclaim.com offers free webinars, basic and advanced educational seminars and on-site claims specialist certification programs for doctors, hospitals and commercial companies, as well as numerous pending national ERISA class action litigation support. Dr. Jin Zhou is regarded as the industry “Godfather of ERISA claims” for healthcare providers.
For any questions, please contact Dr. Jin Zhou, president of ERISAclaim.com, at 630-808-7237.