“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
"Remarkable results"
We make commercial insurers pay.
Even after 10 years.
Through our AI-powered Federal ERISA analysis and appeals process, we can maximize recovery on old uncollectible claims. We work behind other vendors you might have, are contingency based, and can collect where others can’t. ERISA Recovery brings a wealth of intelligence and experience assisting hospitals, bridging the gap without additional stress on hospital resources.
General Services
Learn more about how we can optimize your hospital’s revenue
ERISA Appeals
No upfront costs or hospital resources are needed.
Gain a virtual appeals department that makes full use of the administrative appeal process defined by ERISA that involves automated data-mining of claims to identify ERISA potential.
Claim Denials
Recover all types of complex, dead commercial claims.
Accelerate reimbursement, minimize denials and establish successful core practices over the entire claim cycle via clean claims.
Denials and claims we specialize in.
Underpayments / Zero Balance
Let us quickly identify these unseen revenue opportunities. Auditing for clear evidence of underpayment on claims that we’re confident we can quickly win on appeal. Learn more >
Clinical Denials
Recover claim denials based on common payer objections. For claims concurrent with the patient’s in-house stay and years following discharge. Learn more >
Technical Denials
We’ll identify the best opportunities to reverse denials. Correcting coding errors, providing additional medical records, creating itemized bills, and other administrative tasks. Learn more >
Motor Vehicle Accidents (MVA)
Ensure timely payment on MVA claims. Our proprietary methods and systems expedite investigation into all applicable policies that provide MVA coverage. Learn more >
Workers Comp
Many workers’ comp denials are readily reversible. Quickly find underpaid and denied WC claims that are winnable on appeal. Learn more >
Veterans Administration (VA) Claims
Navigate VA claim processes to expedite reimbursements. We manage documentation, eligibility coordination, and payer follow-ups. Learn more >
Covid Recovery
Recover unpaid and aged claims from 2020. We’ll help formulate a plan and system to appeal specific denials that occurred during the COVID-19 pandemic. Learn more >
Medicare-Medicaid Reimbursements
Ensure uninterrupted and maximized reimbursements across Medicare and Medicaid, including Medicare Advantage (Part C) and other managed Medicare payers. We resolve denials and underpayments unique to MA plans. Learn more >
ERISA ADVANTAGE
Did you know? Some simple ERISA facts.
Turn technical rules into strategic wins. These fundamentals explain why ERISA is a powerful lever for recovering underpaid claims.
Underpayments count as denials
Anything less than 100% of the claim is considered a denial under ERISA — and can be appealed.
ERISA sets the rules of the road
Disputes, claims, and appeals for employer‑sponsored plans must follow precise ERISA procedures.
Self‑insured plans dominate
ERISA governs most self‑insured plans — roughly two‑thirds of all U.S. coverage — where insurers often act only as administrators and network providers.
ERISA supersedes contracts
Network, PPO, and HMO contracts — and even state rules — are superseded by federal ERISA law for applicable plans.
Administrators are agents, not fiduciaries
Third‑party administrators and networks act as the employer’s agents. The employer remains the fiduciary.
Appeals protect revenue
A structured ERISA appeal process helps providers reverse inappropriate denials and capture owed dollars.