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Common Causes of Improper Healthcare Claim Denials
Common Causes of Improper Healthcare Claim Denials One of the most common aspects of patients interacting with the healthcare system...
Multiple Payors and Coordination of Benefits (COB)
Multiple Payors and Coordination of Benefits (COB) One aspect of the healthcare system that frequently leads to confusion and difficulty...
ERISA Health Plan Fundamentals
ERISA Health Plan Fundamentals In the employee-benefits context, an Employer sets up a "employee benefit plan", ("Plan") usually governed by...
ERISA Plan Benefits and Restrictions
ERISA Plan Benefits and Restrictions ERISA does not require an Employer, Plan Sponsor or a Plan to provide either any...
ERISA Plan Funding
ERISA Plan Funding Regarding healthcare coverage, an ERISA Plan can be either "self-funded" or "fully funded". The Plan documents determine...
ERISA Plan Benefit Disputes
ERISA Plan Benefit Disputes If an ERISA healthcare Plan is fully funded, the process for a Provider to appeal a...
Motor Vehicle Accidents and Health Insurance
Motor Vehicle Accidents and Health Insurance One common cause of patients seeking hospital treatment is motor vehicle accidents, generally referred...
Managed-Care Contract Content Issues
Managed-Care Contract Content Issues As discussed elsewhere on this site, one of the things that has become a staple of the...
Overview of Managed-Care Relationships
Overview of Managed-Care Relationships One of the things that has become a staple of the American healthcare system is managed care. There...
Provisions Specific to a Managed Care Relationship
Provisions Specific to a Managed Care Relationship As mentioned, Provider Agreement content falls into four broad categories. The first two, Introduction and Provisions...
General Contract Provisions and Attachments
General Contract Provisions and Attachments As mentioned, Provider Agreement content falls into four broad categories. The first two, Introduction and Provisions Specific to...