Empowering Plans^® Podcast

In the two years since the Federal Trade Commission issued its internal report on PBMs’ role as middlemen, lawmakers have introduced legislation targeting long-standing industry practices. In this episode of the Empowering Plans podcast, Ron Peck, David Ostrowsky, and Kendall…

In this edition of the Empowering Plans podcast, Brian O’Hara and Alex Houle of The Phia Group’s Provider Relations department discuss advancements in Artificial Intelligence, how it is being utilized in healthcare, and the ways providers and health plans are…

In this episode, Garrick Hunt and attorney Kelly Dempsey discuss AI entering the self-funding playing field. From claims administration to the liabilities that may fall on plans and their TPAs, there’s so much to discuss and unfortunately a lot of…

In this episode of the Empowering Plans podcast, we examine real-world claims that spiraled into appeals, IDR proceedings, provider disputes, participant complaints, and potential litigation in order to demonstrate that a plan can make all the right decisions but still…

Tune in for an update from The Phia Group’s CLO, Ron Peck. He’ll bring you up to speed on Phia’s efforts to tackle the hottest topics each month, while also exploring how third-party liability may be contributing to denial and…

What separates a denial that withstands judicial scrutiny from one that does not? In this episode, Cindy Merrell explores the key considerations courts may evaluate when reviewing challenged denials. From investigating the facts to clearly articulating the basis for a…