Resources to Decrease Denied Medical Claims.
Home | Contact Us | Member Benefits | Search | Advertising | Member Area
 JOIN NOW
Become a member & get immediate access to all of our resources.
 SEARCH


Take a Free Tour
About ALO
 Who Should Join
 Download Samples
 Member Benefits
 Terms & Privacy Policy
 Take a Tour
 Member Comments
 Frequently Asked Qs
 Advertising
Discussion Forum
 MEMBER RESOURCES
 Appeal Letters
 Audio Conferences
 Discussion Forum
 Download Library
 Articles & Case Studies
 State Resources
 My Membership
 Virtual Exhibit Hall
 Help
 APPEAL TOPICS
 Providers' Rights
 Benefit Disclosure
 Utilization Management
 Medical Necessity
 Incorrect Payments
 Prompt Pay
 Treatment Excl/Limits
 Refund & Recoupments
 Specialty Care
 ERISA
 Medicare
 Contract Negotiation
 Other Topics
Visit our Online Store.
 Forum Topics
• Horizon BCBS
• EXPERIMENTAL INVESTIGATIONAL
• Humana denying nail debridements when other services rendere
• UBH MNRP - SUBSTANCE ABUSE REV CODES
• UBH substance abuse denial due to rendering provider issue
• Ambulatory Surgery Center Start Date
• Denial based on facility Accrediation in CA
• AUTOMATIC RECOUPMENT-HEALTHPLUS AMERIGROUP
• LA CARE DENIALS
• Medicare denial - referring MD not eligible to refer for ser
• Federal BC pay provider
• Pay the member
• GEHA - DENIED NOT MEDICALY NEC.
• aetna denying anesthesia
• Align Networks
Home | ERISA



Appeal Topics
ERISA

The Employee Retirement Income Security Act of 1974, also known as ERISA, is a federal law applicable to most employee benefit plans, excluding state and federal employees and religious organizations. The Department of Labor estimates that ERISA applies to more than 2.5 million group health plans. Because these plans are exempt from most state regulations, it is important to know and use the ERISA Claim Procedure Regulations and related protections in both treatment verification and appeals.


Topic Areas for ERISA:

Understanding the ERISA Effect
Why do ERISA benefits vary greatly from plan to plan? The ERISA effect on health benefits has been profound. See what it is all about and what you should be doing. . . .more >>

The ERISA Claims Procedure Regulation
ERISA has important claim processing protections. Here is an outline of those protections and a number of ERISA-specific appeal letters. . . .more >>