Phia Group

The Phia Group's Role in Transforming Healthcare with AI

On January 13, 2025
Learn about the merger of The Phia Group & Machinify, focusing on innovative AI technology that streamlines the healthcare claims lifecycle & improves outcomes.

An App for What Ails You

On January 13, 2025
This is the future presaged by “PDURS” (Prescription Drug Use-Related Software). One of the sillier acronyms to grace the healthcare industry in recent memory, PDURS are defined by the FSDA as “software disseminated by or on behalf of a drug sponsor that accompanies one or more of the sponsor’s prescription drugs, including biological drug products.” Essentially, most patients will encounter this software as an app, paired with marquee prescription drugs, that is designed to “assist” patients and healthcare providers in the prescription and use of the medication.

The Phia Group's 1st Quarter 2025 Newsletter

On January 9, 2025
The Phia Group is off to a great start in the first quarter of 2025! Check out our newsletter to get acquainted with some of the latest happenings in our neck of the woods.

The Phia Group Announces the Promotion of John Blaney to Executive Vice President of Transformation and Recovery Services

On January 9, 2025
In its ongoing efforts to be a trailblazer in the healthcare cost containment field, The Phia Group has promoted John Blaney to Executive Vice President of Transformation and Recovery Services. In his new role, Mr. Blaney will spearhead all recovery functions, including subrogation, overpayment, and other cost containment opportunities. Mr. Blaney will leverage his decades of experience serving as an executive in the healthcare field toward streamlining operations as well as automating department-wide processes, all of which will help optimize services offered to Phia’s clients. The Phia Group’s successful growth initiatives and major investments in technology have enabled us to identify more recovery opportunities and deliver higher recoveries to our clients than any other recovery vendor in the market.

Wesco v. BCBSM | Understanding Implications for Healthcare

On January 8, 2025
Explore the implications of the Wesco v. BCBSM lawsuit, focusing on the impact of cross-plan offsetting on healthcare costs and the rights of self-funded plans.

No Extension for Telehealth Safe Harbor in HDHPs for 2025

On January 6, 2025
The telehealth services safe harbor for HSA-qualified HDHPs has expired as of January 1, 2025. Learn about the implications for plan sponsors and participants.

Empowering Plans: P208 – The Evolution of the Birth Control Benefits Mandate

On January 2, 2025
On today’s episode of the Empowering Plans podcast series, attorneys Kendall Jackson and Brian O’Hara discuss the Biden administration’s decision to withdraw proposed rules that would have expanded the birth control benefits mandate. Join us in our discussion of the mandate and how it has evolved throughout the Obama, Trump, and Biden administrations.

Anthem Blue Cross Blue Shield Reverses Anesthesia Policy

On December 26, 2024
Discover Anthem Blue Cross Blue Shield's recent reversal on anesthesia care coverage, which protects patients from unexpected medical bills during procedures.

Empowering Plans: P207 – Denied Claims Beyond the Headlines

On December 19, 2024
On this episode of the Empowering Plans podcast series, attorneys Corey Crigger and Cindy Merrell discuss the murder of UnitedHealthcare’s CEO, which fueled public outcry over denied claims.

Empowering Plans: P206 – Non-Preferred Carrier Fees: Incentives or Control?

On December 5, 2024
In this episode of the Empowering Plans podcast, attorneys Jon Jablon and Brady Bizarro delve into the details of a recent lawsuit where BCBS of Michigan, in its capacity as a TPA, is alleged to have engaged in anticompetitive practices for charging a fee to a group that chose a stop-loss carrier other than BCBS. This case is in its infancy as of December 2024, but we expect it to have noticeable effects on the stop-loss marketplace regardless of outcome. In this episode, Jon and Brady discuss those potential effects and how a holding either way could impact self-funding as a whole.

Health Disparities in Appalachia After Hurricane Helene

On December 2, 2024
Explore the widening health disparities in Appalachia following Hurricane Helene, highlighting the challenges faced by residents and healthcare facilities.

Understanding New MHPAEA Requirements for Compliance

On November 20, 2024
Understand the implications of the new MHPAEA rules, including NQTL requirements & the importance of conducting comparative analyses for mental health benefits.

A New Year, a New Administration, but the Same Old Problem?

On November 19, 2024
On Friday, November 1, millions of Americans awoke from their Halloween slumber only to be further spooked by a New York Times report that employers expect the costs of health benefits to surge as much as 9 percent on average in 2025. How much will the outcome of this month’s elections – held during many companies’ open enrollment period -- impact this now decades-long industry trend? What does this all mean for plans interested in covering big-ticket items like weight loss drugs and next-generation gene therapies in the new year? As 2024 soon merges into 2025, join The Phia Group’s webinar as its panel of experts break down how election results will impact the industry and look ahead to what compliance changes are afoot in just over a month ahead. Indeed, this is a crucible moment for the healthcare industry – and Phia’s Independent Consultation & Evaluation (ICE) team looks forward to lending its expertise.

Addressing Balance Billing and Payment Disputes for TPAs

On November 14, 2024
Discover best practices for TPAs and self-funded employers to address balance billing and post-payment disputes, enhancing compliance and member support.

Empowering Plans: P205 – Lessons From a Florida IDR Case

On November 5, 2024
On this episode of the Empowering Plans Podcast, attorneys Ron Peck and Nick Bonds talk through a recent Florida case addressing judicial review of IDR determinations and highlight some of the key insights and takeaways for any entity subject to the No Surprises Act.