“The lift on our end was minimal and the benefit to cash was immediate.”Matthew Stojakovich, Executive Director Revenue Cycle Shared Services, University of Miami Health System
Get insurance companies to pay what you are due.
When insurance companies underpay and deny legitimate claims, they are in violation of federal law. Federal ERISA law holds them accountable. Its 80,000 pages outlines the appeals process to overturn denied claims that should have been accepted—even those dating back 10 years. Your hospital could recover millions.
"The lift on our end was minimal and the benefit to cash was immediate."
For the protection of hospitals and patients.
Insurance companies do not have the last word on whether they pay a healthcare claim. The federal government does, according to the Employee Retirement Income Security Act (ERISA) of 1974.
For forcing commercial insurers to pay.
Sets strict standards for transparency about employee pension and healthcare plans, which insurers must honor. But despite the law strengthening through amendments over time, most insurance company violations of ERISA go unappealed.
For protection against retaliation
Anti-retaliation rules strictly prohibit insurance companies from withholding benefits as punishment for you to exercise your rights under ERISA. When claim denials are properly appealed, federal law is on your side — even with claims aged up to 10 years.
For reclaiming what’s rightfully yours
Few hospitals, if any, have the knowledge to identify ERISA appeal opportunities or the resources to implement the appeals process. We do.
Articles and White Papers
As hospitals struggled during the pandemic, commercial insurers saw revenue increase as much as 44% as they increased claim denials.¹ Our ERISA strategy converts these denials into recoveries.
Source: Change Healthcare white paper. “A Review of National Medical Claim Denial Trends.”
Denials increased 23% from 2016 to 2020, with the biggest increase falling, cruelly, on regions with the highest first-wave Covid-19 rates.² We target these denials with compliant ERISA appeals.
Source: Amanda Holpuch, The Guardian. “US health insurers report billions in first quarter as small providers face stress.” May 8, 2021.
ERISA claims appeals involving attorneys are eight times more expensive than using ERISA Recovery’s proprietary process.³ Lower cost, faster resolution, stronger results.
Source: Bob Young. Press release for California Workers’ Compensation Institute. “CWCI Analysis Measures Attorney Involvement In California WC.” February 5, 2014.