The Phia Group Blog

By: Ron Peck. Esq. I recently found myself in a doctor’s waiting room.  I overheard another patient arguing with the office administrator.  The gist of it was that he was being balance billed for an amount exceeding what insurance paid. …

By: Garrick Hunt While Super bowl LI was exciting, the commercials were far more revealing. The political motivations for most of the commercials were clear, be it Coke’s America the Beautiful sung in 5 languages to promote inclusiveness or  the…

By: Michael Branco A dialysis claim was adjudicated at the regular out-of-network rate instead of the dialysis carve-out rate of 130% of Medicare. After unsuccessful attempts to recover the overpayment, the TPA, with expectations dashed, asked The Phia Group to…

By: Jennifer McCormick, Esq. Self-funded employers should be careful when selecting networks. In some cases,  low discounts, anti-audit clauses, unseen provider agreements, and upside-down DRGs can cause more problems than the network access is worth. That’s especially true with wrap…

By: Brady Bizarro, Esq. Employers face many, many regulatory burdens. There is an ever-increasing number of federal regulations to abide by (although that might change), and each state maintains its own set of regulations. This can get very complicated. The…

I have personally experimented with paying cash for healthcare. I had sustained a rather nasty cyst/lesion on my chin (basketball accident – I named it Jermaine for the guy that accidently hit me) and I was on the waiting list…