What is ERISA and why should I care?
With an ERISA specialist as your provider, we’ve got your back with treatment and we’ll get your back figuratively by appealing any benefits that are wrongfully denied by your health insurance.
ERISA stands for ‘Employees Rights & Income Security Act of 1974’. ERISA is the set of regulations that governs all healthcare plans given to an employee from an employer in the private sector (non-church, school or government employment).
Many insurance plans may deny rightful benefits that are covered under the Plan to save money. Many doctor’s offices have no knowledge of how to use an ERISA appeal process, and therefore end up billing the patient for the denied claims that should have been covered under their Plan.
Failure to understand and implement an ERISA appeals process often ends up costing patients more money for their healthcare services.
ERISA is all about accountability. Under an ERISA system the health Plan must be accountable for their denials. Many doctor’s offices fail to request disclosure of the ERISA evidence to support the health plans denials and ultimately stick the patient with the bill for the denied services or they may raise their fees to recoup losses from denied services. We know how to properly appeal wrongfully denied benefits to make sure that our patients are able to fairly obtain the benefits covered under their healthcare plan.
For more information regarding ERISA, please contact our ERISA Appeals Manager, Anna, at ERISAappeals@sportsinjurycenters.com