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Learn - Independent Consultation & Evaluation
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Plan - Plan Drafting Services
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Guide to Understanding Subrogation
Moving To Self-Funded Health Plan Guide
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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
FAQs
FAQ - Subrogation & Reimbursement
FAQ - Mass Tort Subrogation & Reimbursement
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Guide to Understanding Subrogation
Moving To Self-Funded Health Plan Guide
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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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FAQ - Subrogation & Reimbursement
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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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Phia Group Media
Unwrapping the Benefits to Your Plan
On May 4, 2023
On January 1, 2022, the No Surprises Act (NSA) officially went into effect, affording protection to patients against surprise medical bills on certain types of claims, including out-of-network emergency services, ancillary out-of-network professional services rendered at in-network facilities, and air ambulance services. While the NSA has spared countless patients from potentially devastating balance bills, its complex and ever-evolving dispute resolution process has created headaches for plans and providers alike. Luckily, Phia Unwrapped includes NSA support services during the Open Negotiation period and, if necessary, Independent Dispute Resolution.
Empowering Plans: P161 – New Challenges to Old Favorites - NSA, ACA, and more (Acronyms)!
On April 28, 2023
In their latest podcast, Attorneys Nick Bonds and Corey Crigger are back to discuss the No Surprises Act (NSA) and the Affordable Care Act (ACA). Join them as they provide an overview of each of these laws and the recent legal challenges out of Nick’s home state of Texas. Will payment determinations resume? Has the ACA finally been struck down? Tune in to find out!
NSA’s Model Notice: Doing Your Own Thing
On November 14, 2022
It’s November, and most TPAs are neck-deep in No Surprises Act compliance. This is a busy time of year as it is – but with new, daunting requirements piled onto a TPA’s usual renewal-time craziness, this is a special year. Some have opined that the last time they had a year like this was when the ACA was first passed, and that’s saying something!
Empowering Plans: P147 – Transparency & More: Burning CAA/NSA FAQs
On October 27, 2022
In this installment of The Phia Group’s Empowering Plans podcast, attorneys Jen McCormick and Jon Jablon bring up some of the most common questions that The Phia Group’s consulting team has been asked to field over and over again. From the so-called broker compensation rules to a TPA’s obligations related to a group’s No Surprises Act compliance, Jen and Jon highlight some of the main points to keep in mind when making important decisions regarding your business.
California Law Still Governs Most Surprise Bills
On April 14, 2022
Learn about the letter California recently issued detailing the relationship between the No Surprises Act and their existing balance billing protections.
A Spooky Surprise: NSA Regulations on IDR Released
On October 19, 2021
Are you aware of the No Surprises Act rules on independent dispute resolution? Learn about its implications for claims and appeals with The Phia Group.
A Teaser! A Rose by Any Other Name…
On October 15, 2021
Learn about the No Surprises Act, why it's important and its impact on appeals, disputes and our Plan Appointed Claim Evaluator (PACE) service.