Phia Group

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.

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.

A Love Letter to Plaintiffs’ Attorneys Everywhere

On June 7, 2022
You know, in the modern information and technological age it is rather easy to forget that we are not in Kansas, anymore, i.e. the 1990s; anything you say or do on the internet can be accessed by the masses, can and will be used against you, and it will never go away. On the same token, it is important to understand the intended audience and perspective of the speaker and even perhaps get to know the person before you judge them based on what I, personally, would consider a (negligent, at worst) throw away phrase.

Theories v. Practicality: The Simplest Answer is Often the Best!

On November 18, 2019
Whether you believe that a breach of contract action against a plan participant is allowed, it’s better to be able to prevent the money from being put at risk. 

Know when to fold ‘em

On July 30, 2018
Winning a case does not always equate to the best outcome. Learn more about the "made whole" doctrine in MA and effective cost containment by clicking here.

Even the best Plans can backfire!

On February 7, 2018
Success is not a given in the world of subrogation/reimbursement. Choose a subrogation firm like The Phia Group who will try to secure everything that is needed for a client. Contact us today to get started!

Nice to see you, 2018. Should we Expect more of the same?

On January 2, 2018
Avoiding reimbursement rights, self-funded plan structure, prudent management of plan assets or disbursement of settlement funds? No one can predict what will happen in 2018 but The Phia Group will be here to handle any subrogation law needs.

A Little 2017 Holiday Cheer… Subrogation Style!

On November 29, 2017
Everything in the subrogation world in 2016 was viewed through the prism of the Montanile decision from the Supreme Court. We take a look back at 2017 and how the Montanile decision was carried out and any other cases that factored into the court's decision. Read more here

Words With No Meaning - Subrogation Accident Questionnaire

On May 1, 2017
Chris shares an example of why it's important to choose your words wisely and make sure you say what you mean when it comes to subrogation accident questionnaires.

U.S. Airways v. McCutchen – Where Are they Now?

On March 29, 2017
We discuss the differences of known self-funded healthcare plans and compare them to U.S. Airways Vs. McCutchen. Learn more.

Court Nixes Health Plan’s Subrogation Claim

On December 23, 2015
A health plan isn’t entitled to reimbursement of $48,000 in medical expenses it paid on behalf of a minor beneficiary who was injured in an all-terrain vehicle accident

The Supreme Court Seeks Solutions to the Latest Challenges to Subrogation Rights in Montanile Case

On December 4, 2015
The facts of the latest healthcare subrogation challenge on the SupremeCourt’s docket will be familiar to many.

FEHBA Preempts Kansas Anti-Subrogation Regulation

On November 3, 2015
The Federal Employees Health Benefits Act preempts a Kansas administrative regulation prohibiting subrogation and reimbursement clauses in health insurance contracts of federal government employees, the U.S. Court of Appeals for the Tenth Circuit ruled