As an employer sponsoring ERISA-covered health and welfare plans, you are legally obligated to communicate the terms of the plan to participants in a summary plan description (SPD). But many plans operate under poorly worded SPDs and leave their sponsors open to liability. You should know how to create a clear and comprehensive SPD, so that you can avoid expensive litigation in the future.
In this audio conference, expert speaker Thomas Force will help you understand what a summary plan description is, what information ERISA requires to be included in the document, and the importance of the information to providers – particularly out of network (OON) providers. You will also learn how to understand the language and terminology of the summary plan description, how to ascertain the important information to determine the amounts allowable, what your appeal rights are, and what procedures are medically necessary.
After attending this session, you’ll be able to read, analyze, interpret, and summarize a summary plan description. You’ll also be able to correctly determine the allowable amounts and medically necessary procedures. Plus, you’ll know your appeal rights – and how to maximize your payment of claims.
Here’s a taste of what this session will cover:
Who Should Attend
Ask a question at the Q&A session following the live event and get advice unique to your situation, directly from our expert speaker.
Thomas J. Force, Esq. is a licensed attorney since 1994 in both state and federal courts in New Jersey and New York, with 27 years of experience in the healthcare and insurance industries. He is the president and founder of The Patriot Group, a full-service healthcare physician advocacy and revenue recovery company providing billing, appeals, collections and follow-up services for healthcare. Thomas is also the former CEO, general counsel and...
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