Sunday, October 18, 2009

ERISAclaim.com Announced the Expansion of its ERISA Litigation Support for the Healthcare Claims in Response to Increasing High Demand from the $6 Trillion Healthcare Denial Management Market

Effective on October 19, 2009, ERISAclaim.com is expanding its Litigation Support Division for healthcare claims in response to the skyrocketing overpayment recoupment dispute and claim denial litigations in the $6 trillion healthcare denial management market. Federal law ERISA governs more than 80-90% of the insurance and benefit payment for non-Medicare claims for 35 years, when inevitable, litigation is the only legal avenue to resolve healthcare claim dispute to avoid more middle-class bankruptcies for 170 million working Americans and their families covered under ERISA plans.

Hanover Park, IL (PRWEB) October 19, 2009 -- Effective on October 16, 2009, ERISAclaim.com is expanding its Litigation Support Division for healthcare claims in response to the skyrocketing overpayment recoupment dispute and claim denial litigations in the $6 trillion healthcare denial management market. Although Federal law ERISA governs more than 80-90% of the insurance and benefit payment for non-Medicare claims for 35 years, ERISA has been very little known to and mostly misunderstood by healthcare providers and even most healthcare attorneys. Compliant and valid ERISA appeals and exhaustion of appeal remedies are required even before any filing of ERISA cases and for almost all successful ERISA litigations. ERISAclaim.com supports and advocates for successful appeals in order to prevail inevitable litigations. In the past 35 years, the absolute majority of ERISA litigations by healthcare providers failed due to the lack of understanding and correct practice of ERISA Appeals by providers and healthcare attorneys.

In light of increasing managed-care litigation under ERISA and RICO on behalf of healthcare providers in an era of skyrocketing healthcare costs in the midst of unprecedented economic recession, ERISAclaim.com is expanding its long-standing ERISA consulting and litigation support divisions and services for more law firms, to assist and support healthcare providers and their attorneys to promptly identify ERISA plans and plan administrators, to secure legal standing from initial patient encounter to inception of litigation, to correctly request for the plan SPD's and relevant plan documents, to effectively and strategically file and complete ERISA appeals, and to provide attorneys with litigation research and strategy assistance.

ERISA, Employee Retirement Income Security Act of 1974, is a federal law that governs and regulates healthcare claims for estimated more than 170 million Americans who obtained health insurance or benefits from employment in private sector, for both self-insured and fully-insured (through purchase of insurance) health plans. ERISA law completely (100%) preempts, supersedes and invalidates any and all state laws and private managed-care contracts for PPOs and HMOs in any and all dispute over denial of benefits from an ERISA plan. ERISA regulates and governs healthcare claims which include the paid ERISA healthcare claims in more than 50% of $2.4 trillion, 16.6% of GDP, of the national health expenditure in 2008, and also include the denied healthcare claims, legitimately or wrongly for appealable claims, in more than 50% of $5 trillion in the aggregated denied healthcare claims in 2008. More than 60-70% of healthcare claim denials from insurance companies and managed-care third-party payers by employer-sponsored plans are due to ERISA regulated plan or policy coverage, limitations and exclusions rather than traditional billing, coding, medical necessity and managed care contracting or participation dispute. Although in the past 35 years the notices for ERISA rights to appeal were written on almost every EOB (Explanation of Benefits) in the daily practice in doctors' offices and hospitals, the healthcare providers, managed-care third-party payers, and even legal professionals as well as the state regulators rarely understood how to conduct, manage or regulate ERISA claim appeals for ERISA claim denials and disputes.

There have been urgent and popular market demands for ERISA healthcare claim litigation as the only legal avenue to resolve healthcare claim dispute, for 170 million working Americans and their families, to avoid more middle-class bankruptcies when 77.9 percent of those bankrupted by medical problems had health insurance at the start of the bankrupting illness, including 60 percent who had private coverage from ERISA plans in this $6 trillion healthcare denial management market.

More and more class action lawsuits have been filed recently under ERISA and RICO on behalf of doctors and hospitals for overpayment disputes in order to avoid provider's financial disasters and bankruptcies. Multi-billion dollars have been reportedly recouped by Payers and managed care TPA's in private sector, in addition to now popular Medicare RAC overpayment program.

ERISAclaim.com is offering the nation's first systematic, comprehensive and advanced ERISA litigation support, when inevitable, for healthcare claims specifically in accordance with U.S. Supreme Court rulings in Aetna v. Davila and ERISA claim regulation, with commitment to compliant education for medical claim dispute resolution in order to avoid all unnecessary costly litigations.

ERISAclaim.com is currently the only company in the country that provides comprehensive, systematic and advanced ERISA healthcare claim education, consulting and publishing primarily for the healthcare providers and industry consultants.

ERISAclaim.com, located in northwestern suburb of Chicago, Illinois, is an online publisher, consultant and educator for ERISA claim education, training and consulting as well as claims recovery for ERISA healthcare claims. It also provides ERISA litigation support, research assistance and fraud and abuse prevention as well as PPO auditing defense consulting. In addition to ERISA, ERISAclaim.com also provides consulting and education for Medicare Claim Appeals Specialist, for Medicare RAC overpayment appeals, fraud and abuse prevention.

Dr. Jin Zhou, the president of ERISAclaim.com, developed the nation's first ERISA education and practical appeal system for healthcare providers 10 years ago. He has gained most comprehensive and unique practical experience in training and consulting in ERISA claims for healthcare providers and assisting trial lawyers frequently for more than 10 years. Dr. Jin Zhou was sometimes referred to as the "Godfather of ERISA Claims" for healthcare providers by some industry experts. His ERISA expertise and experience are unique and different from that in traditional ERISA appeal and litigation for disability claims on behalf of patients instead of healthcare providers with billing and coding, medical necessity and managed-care contracting and network complications.

For more information or to arrange an interview, please visit www.ERISAclaim.com, or contact Dr. Jin Zhou, president of ERISAclaim.com, at 630-808-7237.

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[Via Legal / Law]

Posted by prolink at 9:45 PM

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