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In-Network vs Out-of-Network Claims
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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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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
Empowering Plans Segment 10 - Plan Tales: The Good, Bad, and Really Bad
On June 19, 2017
In this episode, Adam Russo and Ron Peck interview two key members of The Phia Group’s consulting division – Vice President of Consulting, Attorney Jennifer McCormick, and Product Developer, Kristin Spath. These two have tales to tell, regarding their experiences helping clients with unusual questions, and transforming outlandish ideas into real benefit plan innovations.
Empowering Plans Segment 09 - In the Land of the Blind
On June 12, 2017
The Congressional Budget Office (“CBO”) has released its assessment of the American Health Care Act (Version 2.0), and once again the focus seems to be on who will lose insurance, gain insurance, and change insurance. Yet, as lawmakers stumble with blinders on, addressing only the matter of insurance, other important factors – such as the actual cost of care itself – remains conspicuously absent.
Empowering Plans Segment 08 - Healthcares? Alternative Provider Payment Programs
On May 22, 2017
The Phia Group’s CEO, Adam Russo, and Sr. VP & General Counsel, Ron Peck, discuss movements within the healthcare provider community to change how they charge (and receive payment) for services rendered. For better or worse, change is on the way!
Keeping PACE with Appeals, Trends and Fiduciary Responsibility
On May 22, 2017
As TPAs, consultants, and Plan Sponsors utilizing The Phia Group's Plan Appointed Claim Evaluator service, you are entitled to exclusive educational material.
Decisions, Decisions: Which Plan Types Work Best for Which Groups, and Why?
On May 16, 2017
Between a traditional PPO plan, a MEC or “skinny” plan, reference-based pricing, narrow network, cafeteria plan, or high-deductible health plan, who can choose? They all have their nuances, and which plan type is best for a given plan sponsor will depend on factors including risk tolerance, geographical location, employee base, and more.
Empowering Plans Segment 07 - The American Health Care Act
On May 9, 2017
Repeal and replace, the ACA, the AHCA - what does it all mean? How does it affect us? What’s next? Join The Phia Group's CEO, Adam V. Russo, Sr. VP, Ron E. Peck, and Attorney Brady Bizarro as they discuss the American Health Care Act, which passed the House of Representatives on 05/04/2017.
The Double-Edged Sword of Discretion: How Even Great Plan Document Language Can Cause Gaps in Coverage
On April 27, 2017
Nearly all Plan Documents have some mention of discretionary authority. The ability to interpret the terms of the plan is necessary to receive deference from the courts, and is needed since not every conceivable scenario can be planned for within the plan document.
Empowering Plans Segment 06 - An Employer Call to Action
On April 25, 2017
A podcast dedicated to employers. Our goal is to show employers what they can do to improve their health plan and plan performance, without relying on third parties. It’s time for employers to get into the game!
The Phia Group's 2nd Quarter 2017 Newsletter
On April 21, 2017
The Phia Group is off to a good start in 2017! Check out our newsletter to get acquainted with some of the latest happenings in our neck of the woods.
The Stacks – 2nd Quarter 2017
On April 14, 2017
This is “The Stacks” from the Phia Group’s 2nd Quarter 2017 Newsletter
Empowering Plans Segment 05 - The AHCA Failed: Where To Next?
On April 4, 2017
Join The Phia Group's CEO, Adam V. Russo, Sr. VP, Ron E. Peck, and Attorney Brady Bizarro as they discuss the recent, stunning failure of the GOP's American Health Care Act, the most recent news and predictions on the effort to repeal and replace the ACA, and what this all means for the self-funded industry.
The Phia Group, LLC is pleased to announce the addition of “Leave of Absence” reviews.
On March 27, 2017
Recognizing that employee handbooks are rarely compliant with applicable law, and promise employees extended health plan coverage contrary to health plan documents whose terms require termination of coverage, The Phia Group is pleased to provide a Leave of Absence review service.
Medical Bill Blues: Pre-Payment Contracting and Negotiation, Pricing Alternatives, and Post-Payment Recovery of Overpayments
On March 23, 2017
It’s common knowledge that not every network contract adds real value, nor can medical providers always be relied upon to bill responsibly. As the fiduciary duty to be prudent with plan assets becomes increasingly relevant, it's important that self-funded health plans, and those who service them, not fall behind.
Empowering Plans Segment 04 - Attack of the Killer Savings
On March 13, 2017
Join The Phia Group's CEO, Adam V. Russo, and Sr. VP, Ron E. Peck, as they describe how The Phia Group identifies facilities that provide the best outcomes for the least cost, and encourage plan participants to visit those facilities.
Empowering Plans Segment 03 - The Journey Continues
On February 28, 2017
Once again The Phia Group’s CEO, Adam V. Russo, and Sr. VP, Ron E. Peck, delve into what makes their own company’s health benefit plan unique, and share tips employers (and those that service them) can use to improve their own plan’s performance.
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