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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...
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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...
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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...
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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...
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ERISA Plan Funding

ERISA Plan Funding Regarding healthcare coverage, an ERISA Plan can be either "self-funded" or "fully funded". The Plan documents determine...
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ERISA Plan Benefit Disputes

ERISA Plan Benefit Disputes If an ERISA healthcare Plan is fully funded, the process for a Provider to appeal a...
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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...
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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...
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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...
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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...
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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...
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