By Adam V. Russo
October, 2011
It is the buzz word in our industry – fiduciary – and more and more discussions about what it is, and whether or not you want to become one, are taking place throughout the country. It is not very often that I become surprised anymore, but it happened to me back in June and I will never forget the conversation…
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Presented By Adam V. Russo
September, 2011
Unless you have been living under a rock, you know that the Patient Protection and Affordable Care Act (“PPACA”) required the Department of Labor (“DOL”) and the Department of Health and Human Services (“HHS”) to create an annual report for Congress that compares self-funded and fully-insurer plans. After reviewing both reports in details, I can say with confidence that every single TPA in the country should have acopy of each in thier sales and marketing departments…
Read morePresented By Adam V. Russo
July, 2011
There isn’t a third party administrator (“TPA”) who hasn’t been in the dire situation of paying a claim that should not have been paid or was overpaid. There isn’t a TPA that hasn’t overlooked a subrogation opportunity or recovered too little from an overzeaous personal injury attorney…
Read morePresented By Adam V. Russo
June, 2011
The reality of the situation in the self funded world is that overpayments happen! In my experience, most overpayments made by plans occur from an honest mistake. The problem is that not all providers are willing to return the money without a nasty fight…
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