Sustainable revenue cycle management continues to be a challenge for many healthcare providers, with hospital claim denials and delays being one of their biggest concerns. Rejected, underpaid, and written-off accounts can add up and eventually lead to a massive loss of revenue. This is where the Employment Retirement Income Security Act or ERISA can provide much-needed compensation for your medical facility.
ERISA law regulates how employer-sponsored health benefit plans operate. It also gives healthcare organizations the right to seek just compensation for reimbursements lower than expected, delayed, or not granted at all.
Unfortunately, the ERISA claim appeals is a complex legal process, and you’ll need the assistance of a specialist to get the best results. Attorneys specializing in federal law understand the ins and outs of the legislation, so they’re likely to present a winning argument for you.
With this, finding the best ERISA law experts is easier said than done. Save yourself from unreasonably expensive fees and unsuccessful appeals by considering these key factors:
Expertise in ERISA Law
While this sounds like an obvious requirement, it pays to reiterate that you’ll only get the best results for your ERISA claim with a certified expert in the legislation.
The Employment Retirement Income Security Act is complex, and submitting an appeal through ERISA entails looking for appeal opportunities and going through several steps.
A knowledgeable and experienced team like Auraven can leverage its acquired expertise to help hospitals recover denied or written-off revenue. They are also likely to have a technology package you can use to modernize your claims management system and, ultimately, transform your revenue cycle management.
Another point to remember is that the ERISA appeals service provider you choose will also gain access to your crucial information. They will need to access at least your 835 remittance data so they can proceed with your appeal. This is why it’s best to work only with a HIPAA-compliant team.
The Health Insurance Portability and Accountability Act (HIPAA) was signed into law in 1996 to enumerate security provisions for safeguarding medical information held or transferred in electronic form.
When you work with a HIPAA-compliant ERISA specialist, you can rest assured that your protected health information or PHI is safe and secure. These teams adhere to the HIPAA Privacy Rule when mining the denials and underpayment data needed for your appeals process.
Reasonable Payment Arrangements
While plenty of attorneys will promise to work on your ERISA appeal, there will be those who will ask for hefty fees — even just for assembling your case. Appealing for a previously denied, underpaid, or written-off compensation is lengthy, so working with such specialists will only make it more difficult for your organization to revitalize your finances.
As you vet potential ERISA specialists to work with, it’s a good idea to consider those who work on a contingency basis. In this arrangement, your attorney will not get paid unless you do. And the better the outcome for you, the better the reward for them as well.
That’s exactly how we work at Auraven. Our business depends on our performance, giving us every reason to get a settlement in your favor.
Personal and Invested Team
It’s not easy to appeal for denials, underpayments, or written-off accounts on top of managing your healthcare facility’s operations. The ERISA appeals process usually entails performing claims analyses, gathering the necessary documentation, following up with payers, updating your records, and so on.
This is why you’ll never go wrong with an ERISA expert who’s also invested in your organization’s welfare. They go the extra mile in learning more about your cases and finding ways to refute all the reasons why they were rejected.
Most importantly, they do all this while representing your hospital in the best way possible. An experienced team will win cases through their professionalism and expertise in the federal law, not with confrontation or intimidation.
Work With a Team That Checks All the Boxes
The Employment Retirement Income Security Act allows you to collect fair reimbursement for your services. However, the appeals process is often complex and difficult, and you’ll need to partner with a knowledgeable and experienced ERISA attorney to get the best results.
As you find ways to minimize your debt and improve your revenue cycle management through ERISA claims, it helps to keep the above factors in mind as you vet specialists. Doing so will help lead you to professionals with the legal expertise, qualifications, and perspective to fight for and win your ERISA appeals.
If you are struggling with filing successful claims or recovering lost revenue, Auraven is here to help. Our skilled, experienced, and HIPAA-compliant team knows how to leverage the ERISA law to recover up to 50% of your written-off revenue. But most importantly, we guide you through your appeal while ensuring your information remains safe and secure.