Health Reform Law Pays For More Certified PPACA & ERISA Claim Specialists
www.insurancenewsnet.com December 17, 2010
Health Reform Law Pays For More Certified PPACA & ERISA Claim Specialists – More Healthcare Experts Ready To Cash In On New Patient’s Bill of Rights Hanover Park, Illinois (Vocus/PRWEB).
On December 15, 2010, ERISAclaim.com entered an agreement with Yolanda Flores Corporation on Healthcare PPACA & ERISA Claims Specialist Certification training, as the nation’s first generation of PPACA Claims Specialists. New federal claims and appeals regulation went into effect on September 23, 2010, with an enforcement grace period until July 2, 2011, for all group health plans and individual policies in claims reimbursement and denials. Currently, healthcare providers and health plans must substantially comply with existing ERISA claim regulation of 36 years. Beginning 2011, under new health reform law, all non-grandfathered plans must “strictly” and completely adhere to existing ERISA regulations as well as six new requirements for internal appeals and new federal external appeals process.
With over 25 years of experience in successfully serving California medical providers, Yolanda Flores Corporation will become the nation’s first healthcare revenue company with advanced certified PPACA & ERISA claim specialist qualification, to cash in on maximum reimbursement under new Patient’s Bill of Rights Regulations. This PPACA and ERISA certification training class is another development after ERISAclaim.com entered the similar agreement last month with Ohio State Chiropractic Association.
“Why do we say it pays to establish PPACA certification training and how can you cash in on new Patient’s Bill of Rights? Because new PPACA guarantees immediate payment or coverage if you win or prevail on your federal external appeals under PPACA!” said Dr. Jin Zhou, President of ERISAclaim.com, a national expert on ERISA and PPACA appeals and compliance.
Technical Guideline from HHS, IRS & DOL pays to cash in on PPACA compliance:
“4. Reversal of plan’s decision. Upon receipt of a notice of a final external review decision reversing the adverse benefit determination or final internal adverse benefit determination, the plan immediately must provide coverage or payment (including immediately authorizing or immediately paying benefits) for the claim.” [Page 6 of 8] http://www.dol.gov/ebsa/pdf/ACATechnicalRelease2010-01.pdf
“In addition, as a new protection under Patient’s Bill of Rights, PPACA Regulations provide that if an insurance company fails to strictly (100%) adhere to all requirements of the internal claims and appeals regulations, the claimant may initiate an external review and initiate a lawsuit in state or federal court.” further explained Dr. Zhou.
“We finally see the real teeth of ERISA from PPACA after we have felt hopeless and frustrated during the past 10 years when some health plans would ignore our ERISA appeals. New Patient’s Bill Of Rights Regulations will protect those who comply faithfully and punish those who fail to strictly comply,” said Vince Flores, Vice President of Yolanda Flores Corp.
“We are very pleased to be certified as the first generation of PPACA & ERISA Claims Specialists in the health care industry, to cash in on PPACA compliance for our clients, seeking maximum reimbursement through compliance,” said Mark Flores, Director of Compliance of Yolanda Flores Corp.
ERISAclaim.com’s PPACA & ERISA Claim Specialists Certification Programs are established to provide expert guidance in understanding, implementation and compliance with PPACA:
HHS, DOL & IRS: “Fact Sheet: The Affordable Care Act’s New Patient’s Bill of Rights”
http://www.healthreform.gov/newsroom/new_patients_bill_of_rights.html
HHS, DOL & IRS News Release: “Administration Announces New Affordable Care Act Measures to Protect Consumers and Put Patients Back in Charge of Their Care”
http://www.hhs.gov/news/press/2010pres/07/20100722a.html
HHS, DOL & IRS: “Fact Sheet: The Affordable Care Act: Protecting Consumers and Putting Patients Back in Charge of Their Care July 22, 2010
The Affordable Care Act will help support and protect consumers and end some of the worst insurance company abuses. For too long, consumers have been forced to fend for themselves in a health care system that did not provide them with the support and assistance they needed and deserved. Today, the Obama Administration is announcing new regulations that will allow consumers to appeal decisions made by their health plans and the availability of resources that will be used to help give consumers more control of their health care decisions.” http://www.healthcare.gov/news/factsheets/protectconsumers_factsheet072210.pdf
Complete Affordable Care Act Regulations and Guidance can be found on DOL website:
http://www.dol.gov/ebsa/healthreform/
Located in Los Angeles, CA, Yolanda Flores Corp. is a leading multi-facet healthcare solution company with dedicated appeals specialists specialized in billing, coding, revenue recovery services, consulting, claims review and compliance. With many physicians and ambulatory surgical centers as clients statewide, Yolanda Flores Corp has been fighting for the rights of consumers and providers by appealing denials, partial denials and overpayment requests, with the ERISA training from ERISAclaim.com since 2001. For information regarding Yolanda Flores Corp, please contact, Mark Flores, VP, at 213-387-1180.
Located in a Chicago suburb in Illinois, ERISAclaim.com is the only ERISA & PPACA consulting, publishing and website resource for healthcare providers in the country. ERISAclaim.com offers free webinars, basic and advanced educational seminars and on-site claims specialist certification programs for doctors, hospitals and commercial companies, as well as litigation support. Dr. Jin Zhou is regarded as the industry “Godfather of ERISA claims” for healthcare providers.
For more information on how to become an ERISA-PPACA & ERISA Claims Specialist under new and existing federal appeals regulations: http://www.erisaclaim.com/certification.htm.
For any questions, please contact Dr. Jin Zhou, president of ERISAclaim.com, at 630-808-7237.
Read the full story at http://www.prweb.com/releases/2010/12/prweb8030134.htm
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