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In-Network vs Out-of-Network Claims
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The No Surprises Act Explained
Mental Health Parity and Addiction Equity Act Explained
Understanding Non-Quantitative Treatment Limitations (NQTLs)
The Insulin Cap Bill Offers Hope for Americans With Diabetes
In-Network vs Out-of-Network Claims
Gag Clause Prohibition Compliance Attestation
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Guide to Understanding Subrogation
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Balance-Billing: What Patients Need To Know
Employee Rights With COVID-19 Vaccines
The No Surprises Act Explained
Mental Health Parity and Addiction Equity Act Explained
Understanding Non-Quantitative Treatment Limitations (NQTLs)
The Insulin Cap Bill Offers Hope for Americans With Diabetes
In-Network vs Out-of-Network Claims
Gag Clause Prohibition Compliance Attestation
Industry Terms
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Jason Ruhl
Jason Ruhl's Blog
The Phia Group, LLC is pleased to announce the integration of its Flagship Template
On October 6, 2017
The Phia Group, LLC is pleased to announce the integration of its Flagship Template into its acclaimed Phia Document Management (“PDM”) software, and support for The Phia Group Flagship Template by many leading stop loss carriers.
Empowering Plans Segment 18 - Responsibility - Beyond the Contract
On September 28, 2017
In this episode, Adam and Ron discuss trends impacting health plans, employers, and employees. While these issues, such as the opioid epidemic, may not seem like the biggest costs facing benefit plans today, the long term costs are real. More importantly, issues like these can be identified by examining claims data; but most administrators are not contractually responsible to do so. Adam and Ron discuss why these entities should consider adding such services to their offerings – despite not being the most impactful cost containment option or being a contractual responsibility of the administrator.
It’s Time To Renew – Revisiting Stop Loss Trends
On September 21, 2017
It’s that time of year again – renewal season! What is often overlooked is the type of stop loss carrier to partner with for the next plan year. Stop loss choices are often made just on the premium cost, however plans should look at more than just the price. Stop loss is something most self funded benefit plans rely upon to ensure their financial viability and long term success.
Empowering Plans Segment 17 - Cutting Out Conflict
On September 11, 2017
When it comes to securing stop-loss, too many benefit plans think the ball is only in the stop loss carrier’s court. Today, our hosts explain what plan administrators can do to cut out conflict and tie up loose ends before they suffer a costly loss. Ensuring an ongoing and fruitful relationship between plans and stop loss tomorrow requires intensive work today. Addressing these potential costly issues now will guarantee reimbursements are in the bag later.
A True Impact on the Bottom Line – Identifying Current Issues, Implementing Solutions & Seeing Results!
On August 22, 2017
The Phia Group’s legal team frequently addresses the biggest issues impacting the health benefits industry today. Join them as they dissect the conflicts threatening every entity involved in the business of health benefits, and share real life examples of clients who implemented forward thinking solutions… and those that didn’t.
Empowering Plans Segment 16 - In Reference to Reference Based Pricing
On August 22, 2017
This week, Adam Russo and Ron Peck accept that an answer to the high cost of healthcare won’t be coming from D.C., and that health plan administrators (with the help of their partners and advisors) need to address the costs internally. Amongst options to do just that, so-called “Reference Based Pricing” is a hot topic in our industry. Join Ron and Adam as they pick apart this method for containing costs, identify the pros and cons of an “RBP” plan, and discuss options to customize such a program.
Stopping the Bleeding
On August 11, 2017
This week, The Phia Group’s CEO, Adam Russo and Attorney Brady Bizarro interviewed Garrick Hunt, Phia’s Sales Executive, about some of the most common burdens self-funded employers are facing in our industry. From out-of-network claims to air ambulance to specialty drugs, we explore cost-containment strategies and discuss the potential compliance concerns for employers. Finally, we answer a question from our mail bag regarding best practices for handling overpayments.
Empowering Plans Segment 14 - Repeal & Replace Fails: What's Next?
On August 7, 2017
This week, The Phia Group's CEO, Adam Russo, Sr. VP, Ron Peck, and Attorney Brady Bizarro discuss the dramatic events on Capitol Hill and the shocking failure of Senate Republicans to repeal and replace Obamacare. Despite this serious setback, Republicans are not ready to give up. We'll discuss the path forward.
Empowering Plans P13 - Your Friendly Neighborhood Provider
On July 17, 2017
Taking a positive view on the industry, Ron Peck, Jon Jablon and Andrew Silverio today share stories and examples of providers working with payers to preserve the private employer based group health plan industry. From price transparency, to direct primary care, to medical tourism – providers that are willing to innovate and work with payers get their moment in the sun with this episode.
Consulting Headlines – The Hottest Topics in Benefit Plan Administration
On July 13, 2017
Extra! Extra! Have you heard the news? Laws are changing, regulations are shifting, and benefit plans are scrambling to keep up.
The Phia Group's 3rd Quarter 2017 Newsletter
On July 11, 2017
The Phia Group is seeing exponential growth in 2017! Check out our newsletter to get acquainted with some of the latest happenings in our neck of the woods.
Empowering Plans Segment 12 - The Cost of Care
On July 10, 2017
This week, The Phia Group's CEO, Adam Russo and Sr. VP, Ron Peck, interviewed Attorney Jon Jablon - Director of Provider Relations, regarding the seemingly increasing number of excessive charges being billed by providers to health plans, strategies to cut costs, and importantly - ways to work with providers rather than against them, in an effort to implement an arrangement that works for all involved.
The Stacks - 3rd Quarter 2017
On July 7, 2017
This is “The Stacks” from the Phia Group’s 3rd Quarter 2017 Newsletter
Empowering Plans Segment 11 - The Senate Unveils its Repeal & Replace Bill
On June 22, 2017
In this special edition of the Empowering Plans podcast, Sr. Vice President and General Counsel Ron Peck and Attorney Brady Bizarro give their initial thoughts on the Better Care Reconciliation Act. What is in this new bill? What does it mean for the self-funded industry? What is next for healthcare reform?
A Network by any Other Name
On June 22, 2017
PPOs, EPOs, HMOs… The days of simple network categories is past. Today, innovative providers are offering up-front transparent pricing, subscription-based direct primary care (DPC), value based pricing, ACOs, medical tourism, international prescription plans, on-site clinics, telemedicine and direct contracting with “centers of excellence.”
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