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A federal law, ERISA (Employee Retirement Income Security Act of 1974) impacts all U.S. employee benefit programs, excluding governmental plans, benefit plans sponsored by religious organizations, and plans which have only business owners as participants. As a physician, you need to how to use ERISA to get proper reimbursement. Pursuing these claims is not an easy task and many physicians face payment issues. An experienced medical billing company in the U.S., Outsource Strategies International (OSI) helps you deal with the complexities involved in ERISA claims. We help you submit clean claims and recover the payment that is due to you if claims under this category are denied or underpaid.
Call 1-800-670-2809 to speak to our solutions manager and learn how we can help ensure hassle-free ERISA reimbursement.
Comprehensive Insurance Benefit Verification Services
Our insurance verification services are designed to check patient eligibility and to spot gaps and errors in information before the ERISA claims go out. Our team checks each claim with regard to the timeframe for claims processing, benefits, and payment (co-pays, deductibles, and non-covered services). Secondary balances and patient responsibility are identified. We scrutinize the Summary Plan Description (SPD) of a patient’s plan to identify whether it falls under ERISA.
Professional Claim Appeal and Follow-up Processes
Our professional team has a clear knowledge of ERISA and adopts the right strategies to ensure that you receive appropriate reimbursement for your claims. We also work to stop payment recoupments, payment delays and payment denials.
Our follow up team aggressively pursues all unpaid insurance claims. Denials are evaluated and claims that are incorrectly denied. Familiar with the steps of ERISA appeal processes, our team knows how to appeal for
- Retroactive adverse benefit denials
- Inclusive denials
- Experimental denials
- Negative remittances
- Incorrectly paid claims
Follow up on claims is handled via our electronic clearinghouse, insurance websites and telephone. Our team knows how to respond to insurers in disputes and deal with improper denials efficiently and effectively. We also follow up on patient responsibility.
Don’t lose money due to missed appeal opportunities! Contact us at 1-800-670-2809 to know how our ERISA reimbursement services can help your practice.
We serve both contracted as well as non-contracted physicians.