Understanding the Basics of ERISA -- A Little-Known Key to Appeals Success

Event Information
Product Format
Prerecorded Event
Conference Date
Thu, Mar 27, 2008
60 Minutes
Product Description

Using ERISA compliance to overturn denied claims

Between 80 and 90 percent of non-Medicare and non-Medicaid claims fall under the Employee Retirement Income Security Act (ERISA). But what is ERISA and who does it apply to? And more importantly, what can it do for you?

Get the facts on ERISA expert speaker Tammy Tipton, President of Appeal Solutions, Inc, during this 1-hour audioconference. You’ll learn about your rights under ERISA and how to assert those rights during both precertification and appeals. Don’t miss the latest in denials management and how ERISA can affect your success on overturning denied claims.

Who should attend: Anyone responsible for claims processing and appeals, including billers, compliance officers, practice managers, and patient advocates.

Key areas explored include:

Using ERISA in denial prevention efforts

  • Understanding why state insurance laws do not apply to ERISA and what to do.
  • How ERISA affects the verification of benefits process.
  • Who gets the denial information under ERISA?
  • How your assignment of benefits can make or break you.

Conducting ERISA Appeals

  • What is the “authorized representative” under ERISA?
  • Fiduciary vs. administrative services only carriers and where to send appeals.
  • Why requesting information in every appeal is a basic ERISA appeal technique.
  • Heads up: When the appeal/request for information is filed, the clock is ticking.
  • Ambiguity in ERISA plans is in your favor!
  • Legal implication of ERISA non-compliance.

BONUS: You get the following Immediate Implementation Tools:

  • ERISA deadline chart -- quick reference guide to enforcing ERISA claims processing timeframes.
  • Level I sample appeal letters for seeking disclosure of ERISA denial information: useful on almost any type of ERISA denial!
  • Level II appeal letter for requesting expert medical review or expert coding review.

Your registration includes:

  • Risk-free enrollment! Scheduling conflict? No problem! This session is also available on CD!
  • Expert answers to your tough questions during the interactive Q&A period.
  • Complementary attendee package, including the speaker's complete presentation handouts. Keep this quick reference tool close by for future use!
  • One low price for all the staff you can stuff into a conference room!

Order Below Or Call 800-508-2582 Today!

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About Our Speaker

Tammy Tipton - Medical Coding Expert

Tammy Tipton is President of Appeal Solutions, Inc. and the co-author of Power of Appeals Denial Management System. She is the author of “Appeals Toolkit” and “Turning Insurance Denials Into Dollars.” She has written extensively on medical receivables management and has frequently lectured on conducting successful appeals and using today’s complex legal system to protect healthcare claim assets. She has a Paralegal Certification from the University of North Texas. Her...   More Info
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