Medicare Compliance & Reimbursement

If you don't learn the ERISA ropes, you could be losing out in the appeal stages. If you don't know at least the basics of Employee Retirement Income Security Act (ERISA) claims, you're likely costing your practice big bucks in missed appeal opportunities. With more than 80 percent of non-Medicare claims falling under ERISA regulations, you stand to lose a lot by not knowing your stuff. No need to fear: In this two-part series, our experts will answer your top ERISA questions and set you on the path to proper appeals. 1. What Is ERISA Even About? ERISA is a federal law, enacted in 1974, governing insurance plans that are selffunded or paid for by an employer, including group plans, PPOs and HMOs. ERISA does not include Medicare or Medicaid carriers. ERISA was "originally designed to protect an employee's retirement benefits," explains coding, billing, and practice management consultant Steven M. [...]