Phia Group

Empowering Plans: P182 – Navigating Post-Settlement Fund Pursuits

On February 15, 2024
Attorneys Andrew Silverio and Cindy Merrell discuss a newly decided case which provides a roadmap for pursuing settlement funds after disbursement. Who has the burden of proof when the funds have been dissipated? What is lowest intermediate balance rule?

Welcome to the Subrogation Sphere

On February 9, 2024
Las Vegas does not have the only sphere that can provide an extraordinary experience for its participants. Let me introduce you to the subrogation sphere where participants may first appear to have conflicting interests but can become allies. When a health plan member is injured because of a third-party action it sets into motion a dance involving many players, potentially including the plan participant, at-fault party, medical providers, stop loss carrier, and the health plan. Each player is trying to determine which player is the proper payor of the plan participant’s medical expenses.

The Phia Group and Healthcare Recovery Solutions (HRS) Join Forces to Empower Healthcare Payers in Recovering Lost Dollars from PFAS, PFOA and PFOS Payouts

On June 29, 2023
The Phia Group, a distinguished leader in healthcare cost containment, and Healthcare Recovery Solutions (HRS), a prominent healthcare mass tort subrogation expert, announce their most recent and pressing initiative. In response to an environmental crisis in the US, our team is launching a robust initiative to provide unparalleled recovery solutions for healthcare payer clients. Through the integration of our unique and exclusive capabilities, including patented, state-of-the-art mass tort data analytics and subrogation recovery specialists, we will offer an extraordinary opportunity for clients to identify and recover medical costs associated with toxic chemicals known as PFAS, PFOA and PFOS.

Digitizing Subrogation

On May 10, 2023
When it comes to subrogation, The Phia Group has over 20 years’ experience serving clients nation-wide. Our attorneys are some of the industry’s most well-versed subrogation experts who can relate to a wide swath of health plans – from self-insured to Medicare-based ones. But we know there can be a great deal of attrition and stiff competition in the subrogation space, which is why for the better part of the past decade there has been a company-wide initiative to digitize our products, most notably The Phia System™ and Case Management System.

Maximizing Subrogation and Reimbursement in Medical Malpractice Claims

On March 13, 2023
The idea of healthcare subrogation and reimbursement seems straightforward. A third party causes an injury to a plan member and the Plan seeks recovery for the benefits advanced by the health plan from either the at-fault party or from the proceeds of the settlement. However, it can be much more complicated. Some of the most complex cases occur when a plan member makes a medical malpractice claim. Medical malpractice subrogation and reimbursement typically involve high dollar claims and the member is usually suffering from a permanent condition or has died. These cases can be difficult not only for the member who has suffered injuries, but for the health plans as well.

Love is in the (Health)Care!

On February 15, 2023
Roses are red, violets are blue, and The Phia Group has some hot tips for you. Whether you sponsor, administer, or service self-funded health plans, The Phia Group’s free webinar will thrill and amaze you. The Phia Group’s team presented a variety of important issues, best practices, and case studies. From disputes with providers, to subrogation, to regulatory updates, and beyond… this webinar is better than a box of chocolates. Don’t wait to unwrap your gift!

No Matter the Remedy – No Language, No Luck!

On January 23, 2023
Recently, the 9th Circuit, a jurisdiction that has historically not been kind to benefit plans engaging in third party recovery activity, issued a decision that gives life to benefit plans whose participants shirk their obligations to reimburse their benefit plans from settlements they obtain in third-party liability cases.

Healthcare Subrogation and Reimbursement and Why it Matters

On December 8, 2022
Most self-funded employee welfare benefit plans contain a statement in their plan document which allows the Plan to recover benefits in the event a third party caused a member’s injuries. The strength of a Plan’s language is vital to the extent the Plan recovers from the proceeds of a settlement or judgment.

Empowering Plans: P143 - Is Wrongful Death the Death of a Subrogation Claim?

On September 2, 2022
In this installment of the Empowering Plans podcast, attorneys Chris Aguiar and Cindy Merrell discuss the murky waters of wrongful death and healthcare subrogation claims.

Stop Loss and Subrogation | The Phia Group

On July 8, 2022
In this episode of the Empowering Plans podcast, attorneys Chris Aguiar and Cindy Merrell discuss potential obligations of health plans to their stop-loss carriers in the event of a recovery through subrogation.

Empowering Plans: P125 – The Night Before an Emergency Room Visit

On December 22, 2021
This podcast discusses the basics of recovering subrogation dollars. Learn about identifying subrogation opportunities through an entertaining story.

Empowering Plans: P124 – Healthcare Subrogation and Plan Document Requests

On December 10, 2021
This podcast talks about what a health plan should do in the event of a pesky U.S.C. 1024(b)(4) records request. Listen to learn more details.

Empowering Plans: P118 – You Can’t Always Get What You Want

On September 17, 2021
Our experts discuss what happens when limited settlement funds force Plans to consider a reduction. Learn more in this podcast by The Phia Group.

"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.