ERISA is the best but most underutilized appeal method in recovering underpaid/denied claims. It is a complex method that needs expert help in order to be successful.
ERISA was signed into law in 1974. The final rule was effective on January 1, 2003 which would technically allow you to appeal on claims back that far but we recommend no more than 3 years in the past due to possible authorization challenges. It works for both in network and out of network as well as fully funded or self funded/self insured plans.
Some of the denial reasons ERISA handles
Exceeds Maximum Allowable/Usual Customary & Reasonable
Not Medically Necessary
Data Insight repricing
WHY CHOOSE TITAN?
More revenue: Our ERISA Solutions help you claim more of what's yours.
Minimal effort, maximum results: Our team consists of ERISA experts who will navigate the complexity of ERISA denials.
Cost effective: We only get paid when you get paid.
Navigate ERISA-Denied Claims with Titan Health Management Solutions
ERISA underpayment represents a significant revenue loss for already-overwhelmed healthcare providers who lack the time or staffing to navigate the complex law and give each appeal its due diligence.
The risk of investing in a full department to handle appeals is too high to be worthwhile. Training is difficult, and return on investment is not guaranteed.
But at Titan Health Management Solutions, we’re experts in navigating those challenges. Our specialists cover multiple sources of ERISA underpayments and gain maximum return for underpayments.