How The Phia Group Contains Costs for Your Health Plan

The Phia Group’s purpose is to make health benefits more affordable for employers and employees. We achieve this through our claim recovery services, specializing in the reduction of healthcare costs. We are hired by health plans, including yours, to maximize the plan’s savings and member experience

The Phia Group receives and reviews all medical claims that are processed by your health plan to gather additional details regarding your treatment and to determine if someone other than your health plan is responsible for payment of the resulting medical claims.

HIPAA is a privacy rule that provides federal protection and patient rights for your personal health information.  The information covered by the rule is called “Protected Health Information” (PHI).

Your personal health information is 100% confidential. Every employee at The Phia Group is required to know the HIPAA rules before they are allowed to handle your personal health information. This information and your privacy are important to us! The Phia Group ensures that all PHI is secure, confidential and safe at all times.

The Phia Group is responsible for collecting the details relating to medical services you receive that may have been the result of an injury or accident.  The Phia Group then uses this information to help protect the plan’s assets by determining if there is another party responsible for claims incurred.

Please contact the customer service number on the back of your medical ID card. Your insurer will be able to verify the relationship and that it is safe to provide The Phia Group with the requested information.

The questionnaire is used to investigate whether a particular injury or illness was caused by toxic exposure, a dangerous medication or a medical device. If the injury or illness is incorrect, let us know.

A mass tort is a type of lawsuit in which many individuals (plaintiffs) file claims against a single defendant for injuries caused by the same or similar actions or products. Common examples can include defective drugs or medical devices, asbestos exposure, plane crashes or environmental contamination.

Yes. This information will allow us to update our records and ensure that you are not receiving letters for health concerns that may be ongoing.

We may need more information to complete our process thoroughly and would still ask if you would once again provide the information so that we can ensure receipt. We apologize for any inconvenience.

It is possible that when you received this treatment, you were still receiving benefits under this benefit plan.

Often a person can be exposed to a dangerous substance or device and suffer injuries or illness as a result. Sometimes, the link between that hazard and the injuries is not discovered for many years. As a result, it is possible that we have only recently been made aware that the hazard you were exposed to years ago caused a particular condition, which is why the treatment is being questioned now.

Healthcare Recovery Solutions (HRS) is an organization that specializes in identifying medical claims that were caused by exposure to a toxic substance, defective medical device, faulty product or dangerous medication. You may not be aware that your illness or injury was caused by one of these hazards and that you and your health plan or fund may be able to recover from the third party that caused your illness or injury. The Phia Group has partnered with HRS to identify, investigate and pursue these opportunities for you and your health plan or fund to potentially recover money paid from potentially liable third parties.

Please let us know whether you are represented by an attorney and provide us with that attorney’s name and contact information, so that we can follow up directly with your attorney.

Yes. The Phia Group can refer you to a law firm if requested. The law firm will advise you of your legal rights and can assist you in filing a claim against the potentially liable parties.

You can contact us with the details one of three ways:

• Call our Customer Service Department toll-free at the number provided on the letter received.
• Email the address provided on the letter received.
• Mail the complete questionnaire in the envelope provided.

The Phia Group’s Customer Service Department hours of operation are Monday through Friday, 8am to 8pm Eastern Time.

The Phia Group’s main office is located in Canton, Massachusetts. The Phia Group also has several locations around the United States, including a regional office in Louisville, Kentucky, as well as employees located in Idaho, Ohio, and Connecticut among other states.