Your Right To Appeal

Health care and the processing of claim is not a perfected science. Claims get coded incorrectly by providers’ offices, sent with incorrect ID information, or processed incorrectly through benefit plans. For health care consumers, it can take some digging and effort in order to get these matters corrected. Sometimes, it even takes an appeal (or multiple appeals).

Based on a recent article by Money Magazine:

·         15% of health claims are denied

·         14% of denied claims are appealed

·         50% of appeals are successful

As patient advocates for our clients, the McGohan Brabender Customer Care Team acts as the patient advocate – mentioned in section 4 – to help identify errors, craft appeals, and escalate the battle when necessary.

Make sure to check out Money Magazine’s article for more information on your right to appeal!

Tax Excise Chart

As a follow up to our last article regarding COBRA/FMLA compliance, today we are sharing a great excise tax chart created by Christine Roberts of Mullen & Henzell. Ms. Roberts has a fantastic blog, E is for ERISA, that I encourage you to reference for employee benefits update information.

The chart created by Ms. Roberts explains how failure to comply with COBRA, HIPAA, GINA, Mental health parity, Insured plan nondiscrimination rules, internal claims and appeal requirements, and/or external review procedure can result in excise taxes for the employer, insurer, HMO, and/or TPA. You can check it out here for a better understanding of what non compliance could mean for your group.