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The Phia Group Announces the Formation of Legal Compliance & Regulatory Affairs Team

December 14, 2018 - For Immediate Release

Braintree, MA -- The Phia Group LLC, one of the health benefit industry’s leading cost-containment service providers, announced that it has completed the formal creation of its internal Legal Compliance and Regulatory Affairs (“LCARA”) team.

The members of this Phia Group Consulting (“PGC”) subdivision will handle the most complex Independent Consultation and Evaluation (“ICE”) queries while performing in-depth research meant to benefit both The Phia Group, and its partners. Led by its Director of Legal Compliance & Regulatory Affairs, Brady Bizarro, Esq., as well as Compliance & Oversight Counsel, Andrew Silverio, Esq. and Compliance & Regulatory Affairs Consultant, Philip Qualo, J.D., the LCARA team will diligently track statutory and regulatory changes, to ensure both the continued compliance of The Phia Group as well as its clientele. By focusing both on the company’s own internal needs as well as the needs of its clients, the LCARA team represents a new stage in “crowd sourcing” information and experience.

“There are certainly a few individuals here or there who include this type of work in their list of responsibilities,” The Phia Group’s CEO Adam Russo remarked, “But we are confident that no team has ever been so focused on remaining ahead of legal challenges, and ensuring that both The Phia Group and its allies learn – and benefit – from each other’s growth, wins, and losses.”

To learn more about The Phia Group, its regulatory compliance services, or any of its offerings, please contact The Phia Group’s Sales Executive, Garrick Hunt, at 781-535-5644 or Info@PhiaGroup.com.

About The Phia Group

The Phia Group, LLC, headquartered in Braintree, Massachusetts, is an experienced provider of health care cost containment techniques offering comprehensive claims recovery, plan document and consulting services designed to control health care costs and protect plan assets. By providing industry leading consultation, plan drafting, subrogation and other cost containment solutions, The Phia Group is truly Empowering Plans. Visit www.PhiaGroup.com.


The Phia Group, LLC Announces Expansion of Exclusive U.S. Relationship with Jason C. Davis Consulting (“JCDC”)

November 20, 2018 – For Immediate Release

The Phia Group, LLC Announces Expansion of Exclusive U.S. Relationship with Jason C. Davis Consulting (“JCDC”) and the Onboarding of Nick Fitzsimmons.

Braintree, MA.  The Phia Group LLC, one of the health benefit industry’s leading cost-containment service providers, announced today that it has agreed to expand upon its existing exclusive consulting agreement with JCDC through the addition of Nick Fitzsimmons.  Mr. Davis and Mr. Fitzsimmons will assist The Phia Group with sales and product development as it relates to its suite of Provider Relations services, including but not limited to Claim Negotiation & Signoff and “Phia Unwrapped.”

“How plans process claims, apply new pricing methodologies, and interact with healthcare providers will determine who thrives in the years to come,” remarked Adam Russo, CEO of The Phia Group, “Jason and Nick are here to help us and our partners reach the next level as it relates to this increasingly important topic.”

Prior to becoming independent consultants, Jason Davis and Nick Fitzsimmons helped manage the U.S. Markets for Global Excel Management and have a combined provider relations experience of over 35 years.

“Though we consult in other markets, we wanted one exclusive, long-term strategic partnership in the United States; and The Phia Group’s innovative, forward thinking attorneys and industry specialists – with their energy, market presence, and industry know-how – just seemed like a good fit for us,” stated Jason Davis.  Nick Fitzsimmons explained, “I look forward to further enhancing the already incredible collaboration between JCDC and The Phia Group.  Together we will continue to positively impact the viability of the benefit plans they service, and improve the lives of their plan members, by building products and services that are uniquely valuable, and distinctly Phia.”

To learn more about The Phia Group, its Provider Relations services, or any of its offerings, please contact The Phia Group’s Sales Executive, Garrick Hunt, at 781-535-5644 or Info@PhiaGroup.com.


WestView Capital Partners Completes Growth Investment in The Phia Group

September 17, 2018
Braintree, MA and Boston, MA


The Phia Group, LLC (“Phia” or the “Company”), a provider of outsourced cost containment and payment integrity solutions to healthcare payers, today announced that it has received a growth investment from WestView Capital Partners.

Headquartered in Braintree, MA, the Company’s comprehensive suite of outsourced tech-enabled services enables healthcare payers to maximize health benefits while offsetting the rising cost of healthcare, making healthcare more affordable for their beneficiaries. As one of the leading experts in the self-funded health plan industry, Phia provides plan administrators and their groups with on-demand, knowledge expert services and support, spanning the clinical, regulatory compliance, and reimbursement aspects of the claims and benefits administration process. Phia’s tech-enabled, data driven subrogation and claim recoupment platform has been proven to drive the highest recovery and savings rates in the industry, while its consultative and cost containment services are universally recognized as industry leaders in both innovation and outcomes.

“Phia is committed to being on the forefront of the rapid changes occurring every day in healthcare, and specifically in the self-insured market, ensuring our clients have the right tools and information to control costs and protect their plan assets,” said Adam Russo, CEO of Phia. “We are firm believers that the self-funded market will continue to rapidly grow and evolve and are thrilled to have partnered with WestView, whose longstanding focus not only on healthcare technology and outsourcing but specifically the reimbursement and claims payment ecosystem will help us capitalize on the numerous opportunities we see out in front of us.”

“Through years of hard work and dedication, Phia has positioned itself as a thought leader and knowledge expert in the healthcare cost containment market,” said Matt Carroll, General Partner at WestView, who will join Phia’s Board of Directors along with WestView colleagues Jeff Clark and Kevin Twomey.  “Adam Russo and his team epitomize the type of passionate and creative entrepreneurs we have built WestView around, so it is only fitting that Phia is the first investment in our latest fund,” added Carroll.

WestView was represented by Latham & Watkins with senior debt financing provided by Abacus Finance Group while Phia was represented by Covington Associates and McLane Middleton.

About The Phia Group:

The Phia Group is a provider of outsourced cost containment and payment integrity solutions for healthcare payers and the entities that service them. Through innovative technologies, legal expertise, and focused, flexible customer service the Company strives to maximize health benefits while reducing healthcare costs for plan administers and their beneficiaries. The Company’s tech-enabled, knowledgeable experts and service offering span the clinical, regulatory compliance, and reimbursement aspects of the claims and benefit administration process, including plan document drafting, subrogation and overpayment recovery, claim negotiation, plan defense and consulting services, all of which are designed to control costs and protect plan assets.

About WestView Capital Partners:

WestView Capital Partners, a Boston-based private equity firm focused exclusively on middle market growth companies, manages approximately $1.7 billion in capital across four funds. WestView partners with existing management teams to sponsor minority and majority recapitalizations, growth, and consolidation transactions in industries such as healthcare technology and outsourcing, business services, software and IT services, consumer, and growth industrial. WestView invests in companies with operating profits between $3 million and $20 million with investment sizes ranging from $10 million to $60 million. For more information, please visit www.wvcapital.com.

 


The Phia Group, LLC is pleased to announce the integration of its Flagship Template
For Immediate Release
October 6, 2017
 
Braintree, MA – 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.  
 
Recognizing that delays in plan drafting cause many plans to administer old plans – or in some cases – no plan, early in 2017 The Phia Group announced that it had compiled decades of experience servicing various types of plans to develop its Flagship Template.  The Phia Group’s Flagship Template is a complete version of its industry acclaimed, fully customizable plan document template, but users’ time commitment is substantially reduced thanks to The Phia Group having already created a nearly complete plan document.  By populating the document with what it deems to be the best provisions in every regard and applying best practices to create an almost-complete SPD, users enjoy a compliant and innovative plan in comparatively no time at all.  All that remains is for the plan sponsor or its named administrator to fill in their biographical information, insert their selected schedule of benefits, eligibility criteria, and review the language already provided to request edits or revisions.  
 
Building upon this foundation, The Phia Group is now proud to announce that its Flagship Template has been uploaded to its acclaimed Phia Document Management (“PDM”) software, ensuring subscribers can now use and offer The Phia Group Flagship Template to their clientele.  Further, following in-depth review and assessment, The Phia Group Flagship Template is now supported by many leading stop loss carriers as well.
 
“We continue to work towards the evolution of benefit plan documents and self-funding.  Each step we take in the advancement of The Phia Group Flagship Template is also a step forward for our industry.  We will not allow time constraints to limit the quality of our clients’ plan documents.  With The Phia Group Flagship Template, speed and quality are both possible.  Our mission was to reduce the number of questions users need to answer, and we did that – reducing them by 75%.” Remarked The Phia Group’s CEO, Adam V. Russo, Esq.
 
Regarding what’s next for The Phia Group Flagship Template, Mr. Russo advised, “Achieving buy-in from the stop loss industry, as well as adding it to our PDM program, is just the beginning.”   
 
For more information regarding The Phia Group’s Flagship Template, or to learn about any of The Phia Group’s other services, please contact Tim Callender by email at tcallender@phiagroup.com or by phone at 781-535-5631.
 
About The Phia Group:
 
The Phia Group, LLC, headquartered in Braintree, Massachusetts, is an experienced provider of health care cost containment techniques offering comprehensive claims recovery, plan document and consulting services designed to control health care costs and protect plan assets.  By providing industry leading consultation, plan drafting, subrogation and other cost containment solutions, The Phia Group is truly Empowering Plans.


The Phia Group, LLC is pleased to announce the addition of “Leave of Absence” reviews.
Braintree, MA – The Phia Group, LLC is pleased to announce the addition of “Leave of Absence” reviews.  

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.  The Phia Group’s team of plan document experts and attorneys will analyze the applicable plan document side-by-side with the employer’s handbook and stop-loss policy, to ensure there are no gaps in coverage and that all are in compliance with applicable law.  

“Too often we see employees – and their employer – caught unawares by limits existent in their own plan document.” remarked The Phia Group’s Vice President of Consulting, Jennifer McCormick, Esq., “Employers enact generous policies regarding leaves of absence, reflected in their handbooks, but totally forget to update their health plans accordingly.”

For more information regarding The Phia Group’s Leave of Absence Review, or to learn about any of The Phia Group’s other services, please contact Tim Callender by email at tcallender@phiagroup.com or by phone at 781-535-5631.

About The Phia Group:

The Phia Group, LLC, headquartered in Braintree, Massachusetts, is an experienced provider of health care cost containment techniques offering comprehensive claims recovery, plan document and consulting services designed to control health care costs and protect plan assets.  By providing industry leading consultation, plan drafting, subrogation and other cost containment solutions, The Phia Group is truly Empowering Plans.



The Phia Group Appoints Tim Callender, Esq. as Vice President of Sales & Marketing
The Phia Group Appoints Tim Callender, Esq. as Vice President of Sales & Marketing

Braintree, MA – The Phia Group, LLC is pleased to announce the appointment of Attorney Tim Callender to the role of Vice President of Sales & Marketing.

The Phia Group benefits from its reputation as a forward thinking advocate for the employer based and self-funded health plan industry. In this newly established role, Tim will provide customer guidance, brand development, and lead The Phia Group in its offerings to the industry. Sales Executive, Garrick Hunt, will continue to serve in his vital role and benefit from Tim’s leadership and industry expertise.

Tim brings with him over 10 years of legal and business experience, ranging from private legal practice, to various industry association board memberships and his time as general counsel for a large TPA.

Commenting on his new role, Tim stated, “This new role is a natural progression and a perfect fit. I’m very fortunate that my career has allowed me to learn the ropes of the self-funded industry first from the TPA perspective and then grow that knowledge from within The Phia Group’s industry-wide footprint. With my legal background, I know that I am uniquely positioned to understand the nuances and legal difficulties presented to those within our industry and then work to apply solutions best suited to fit those needs.”

The Phia Group’s CEO, Adam V. Russo, remarked, “Tim is an attorney who has walked in the shoes of our clients, and spent the majority of his career defending them. As the VP of Sales and Marketing, Tim will once again be called upon to improve the standing of our industry – by sharing opportunities to work with The Phia Group and benefit from our efforts, products, services, and ideas. His legal acumen, ability to communicate in any forum, and overall leadership qualities make him a perfect fit for this new role.”

For more information regarding Tim’s new role and The Phia Group’s many services, please contact Attorney Callender by email at tcallender@phiagroup.com or by phone at 781-535-5631.

About Timothy Callender, Esq.

Tim was raised in the pinnacle business environment – a successful, family-run cattle operation in central Idaho. Tim began practicing law in Boise in the early 2000s before transitioning to the role of in-house legal counsel for a third party administrator where he learned the ins and outs of the TPA world and the self-funded industry as a whole. Tim has spoken on a variety of industry topics at respected venues such as the Society of Professional Benefit Administrators (“SPBA”) and the Health Care Administrator’s Association (“HCAA”). Tim currently sits on the Board of Directors for the HCAA as well. In the past year, Tim has held a leadership role within The Phia Group, directly related to Phia’s Plan Appointed Claim Evaluator (“PACE”) service as well as Phia’s Independent Consultation and Evaluation (“ICE”) service. Tim works out of The Phia Group’s Boise, Idaho office.

Independent Consultation & Evaluation
The Phia Group, LLC Officially Announces the Release of its New “Independent Consultation & Evaluation” (ICE) Service

Braintree, MA – The Phia Group has for more than a decade been a source of document review, claim analysis, and regulatory compliance consultation for the health benefits industry. Today, statutory changes are occurring with greater frequency, and the industry needs objective analysis and expert consultation now more than ever before.

Unfortunately, hourly billing (the method by which most legal consultants charge clients) tends to be difficult to budget, predict, and afford. Rather than force clients to choose between dealing with open ended invoices and addressing difficult situations without assistance, The Phia Group now offers a consultation service featuring a per-employee per-month subscription fee.

“From business development and third party contract review to the application of ambiguous plan exclusions in unusual circumstances, you need legal consultation. To address regulatory compliance concerns, claim processing queries, and to collaborate on difficult administrative tasks, having an experienced team of attorneys and industry experts on call is a must have,” remarked The Phia Group’s CEO, Adam V. Russo, “The Phia Group understands, however, that the cost can be prohibitive – until now.”

The Phia Group’s Senior Vice President and General Counsel, Ron E. Peck, remarked, “We believe that we are all ethically obligated to seek out objective, professional feedback in response to difficult situations. When the cost of such aid increases as the time spent on the matter extends, those who bill by the hour are rewarded for delays, and clients are punished for seeking out thorough review. The Phia Group opposes that inherent conflict of interest.”

With an ICE subscription fee, clients can preemptively budget for and share the cost of this invaluable resource – allowing The Phia Group and their clients to focus on what is really important – results.

For more information regarding ICE and The Phia Group’s many other services, please contact The Phia Group’s Sales Executive, Garrick Hunt, by email at ghunt@phiagroup.com or by phone at 781-535-5644.


Less Takes More - The Phia Group Addresses the Summary of Benefits & Coverage Requirement

Benjamin Franklin, Blaise Pascal, and Mark Twain are all credited with having said, “I would have written a shorter letter, if I’d had the time.” Unfortunately, efforts to simplify complex matters often constitute the greatest challenge. This fact of life is certainly proven by the Affordable Care Act and its requirement that health plans provide consumers with a concise document detailing, in plain language, information about plan benefits and coverage. This summary of benefits and coverage document ( or “SBC”) is meant to help consumers better understand the coverage available to them, and allow them to easily compare options by summarizing key features such as the covered benefits, cost-sharing provisions, coverage limitations and exceptions.

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The Phia Group, LLC Comments on Recent Industry Developments

These last few weeks have brought with them a whirlwind of controversy and concern. The Phia Group, LLC is pleased to announce that it will be addressing three of the hottest topics during its monthly webinar. If you have not yet signed up for our FREE webinar, to be held on Thursday, October 30th, 2014, from 1:00 – 2:00 PM EST, then you will most certainly be missing out!

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