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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
Members Area
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FAQ - Subrogation & Reimbursement
FAQ - Mass Tort Subrogation & Reimbursement
Questionnaire Response
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Save - Claim Negotiation & Signoff (CNS)
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Blog
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+
Industry Articles
Guide to Understanding Subrogation
Moving To Self-Funded Health Plan Guide
Referenced-Based Pricing Explained
Hospital Price Transparency Guide
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
+
Members Area
+
FAQs
FAQ - Subrogation & Reimbursement
FAQ - Mass Tort Subrogation & Reimbursement
Questionnaire Response
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Industry Articles
Guide to Understanding Subrogation
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Referenced-Based Pricing Explained
Hospital Price Transparency Guide
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
Phia Group
Phia Group Media
IMPLANT WARS!
On January 14, 2015
IMPLANT WARS: How monitoring provider self-referrals, & negotiating based on actual costs can result in major plan savings!
"In Reference To The FAQ"... The DOL FAQ Dissected - Part Deux!
On November 20, 2014
Join The Phia Group’s CEO, Adam V. Russo; Sr. VP & General Counsel, Ron E. Peck; and other members of the legal team as we continue to dissect the FAQ, its key provisions, and how it impacts “RBP Plans .
Creeping Around Pitfalls on the Way to Scary Savings? - How to Avoid Horror When Implementing Cost Containment Schemes
On October 30, 2014
DON’T MISS OUT! Whether you’re embarking on a new cost containment adventure in-house, or with the help of a vendor, most programs are not simple “plug and play” affairs. Those who head into the dark unprepared will undoubtedly find themselves spooked by what hides around the corner.
Plans For The Future
On September 24, 2014
Join The Phia Group’s CEO, Adam V. Russo, Esq., as he and Senior Vice President and General Counsel (Ron E. Peck, Esq.), Vice President of Consulting (Jennifer McCormick, Esq.), and a team of expert plan drafting specialists discuss the Phia Document Management system, innovative plan design, and why it is especially relevant in light of changes we predict all plan documents will be required to undergo in the coming years.
"Dude, Where's My Subro?" - Integrating Subrogation - Sought by Employers & Loved by Administrators
On May 15, 2014
As plan sponsors and administrators examine their benefit plans in light of recent legal upheaval, now is our chance to implement important cost containment mechanisms.
Taking It To The Limit - Accurately Identifying and Taking Advantage of Network Contractual Boundaries
On March 27, 2014
While it is true that some network contracts restrict a benefit plan’s ability to audit claims – or as is more often the case, simply prohibits the benefit plan from doing anything with the information so identified; some contracts apply unrealistic deadlines and still others contractually compel payment of claims otherwise excluded by the plan document… There are key provisions plan administrators can use to limit or eliminate the negative impact of such provisions.
To Pay or Not To Pay - Examining Exclusions, Definitions, and Other Things That Really Matter
On February 12, 2014
Whether you are a plan administrator or claims processor trying to determine eligibility of a claim, or a stop-loss carrier trying to determine whether a submission is reimbursable, how applicable provisions apply to specific facts make all the difference.
A Look Behind, A Look Ahead, Lessons Learned in 2013, and Predictions for the Coming Year
On January 8, 2014
Join The Phia Group as we review the biggest issues dealt with in 2013, the lessons learned, and what we expect to be dealing with in the year to come.
What You Don't Know Can Hurt You!
On November 20, 2013
As with the Loch Ness Monster and Bigfoot, we have all long believed that Provider Network Agreements exist solely in myth alone, never to be seen by human eyes… until now! From legend to reality; The Phia Group has obtained many provider network agreements, gone through them with a fine tooth comb, and present to you their expert analysis.
2014 & Beyond - Reacting to PPACA's Volatile Evolution
On September 25, 2013
Health Insurance Reform (aka Obamacare, aka PPACA, aka Healthcare Reform) has not enjoyed a smooth implementation. In fact, its birth has been quite turbulent. Are you surprised?
What's Good for the Goose is Good for the Gander? Analyzing BUCA-ASO PPO Agreements!
On August 20, 2013
Join The Phia Group’s CEO – Adam V. Russo, Esq. – as well as its Sr. VP & General Counsel – Ron E. Peck, Esq. – as they dissect contractual terms existing between carriers and their network providers, and share the realization that they know exactly what is important to you.
Ensuring Cost Containment Success - Member Outreach & Support
On July 31, 2013
On July 31st at 1 PM EST, The Phia Group’s CEO – Attorney Adam V. Russo – and The Phia Group’s Sr. VP and General Counsel – Attorney Ron E. Peck – will address one of the most pressing issues facing our industry today – balance billing.
Providing For The Future - The Evolution of Plans' Provider Relationships & Exposing Conflicts Between Plans & Providers
On May 22, 2013
For those that are invested in maintaining health benefits, inventing new cost saving methodologies is the “holy grail.” Enter the provider – hospitals, physicians, and other health care facilities.
Get In Line Before You're Out Of Time - How To Thrive in a Post-PPACA World...
On April 25, 2013
In a world dominated by reform and regulation, there are those who master compliance and thrive, and those who stumble under the burden.
Getting Employers To Self-Fund In The PPACA Era - Keep Existing Clients Self-Funding... Get New Employers To Self-Fund...
On March 13, 2013
As time passes and elements of PPACA are triggered, the cost of purchasing insurance has become too great. Meanwhile, employers see an opportunity to drop coverage, pay a relatively small penalty, and exile employees to the exchanges.
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