Phia GroupPhia Group Mediahttps://phiagroup.com/Media/PostsProtecting the Most Vulnerablehttps://phiagroup.com/Media/Posts/PostId/1271/protecting-the-most-vulnerableBlog,Balance BillingThu, 24 Aug 2023 17:21:46 GMT<p style="margin-bottom: 15pt; margin-right: 0in; margin-left: 0in; text-align: justify;"><span style="font-size:11pt"><span calibri="" style="font-family:"><span style="font-size:12.0pt"><span style="color:#374151">By: Corey Crigger, Esq. </span></span></span></span></p> <p style="margin-bottom: 15pt; margin-right: 0in; margin-left: 0in; text-align: justify;"><span style="font-size:11pt"><span calibri="" style="font-family:"><span style="font-size:12.0pt"><span style="color:#374151">In February 2022, we received a balance bill referral that was truly exceptional, but for all the wrong reasons. Our client received a staggering bill of over $675,000.00 after a premature delivery with major complications resulted in a two-month stay in the NICU. It was an unjust financial burden exacerbating an already challenging situation.</span></span></span></span></p> <p style="margin-bottom: 15pt; margin-right: 0in; margin-left: 0in; text-align: justify;"><span style="font-size:11pt"><span calibri="" style="font-family:"><b><span style="font-size:12.0pt">Our Efforts to Help:</span></b> <span style="font-size:12.0pt"><span style="color:#374151">We immediately sprang into action, aiming to halt collection efforts while devising a strategy to achieve desired results. While the provider was unwavering in their stance, our #PatientDefenseProgram Partner Firm came to our aid. After over a year of negotiations, the provider eventually agreed to a settlement of an additional $50,000. </span></span></span></span></p> <p style="text-align: justify;"><span style="font-size:12.0pt"><span style="line-height:107%"><span calibri="" style="font-family:"><span style="color:#374151">This isn't just a victory for The Phia Group and the Balance Bill SafeGuard program; it's a triumph for a family that should never have been subjected to this ordeal. If you're seeking to protect your clients from similar situations, get in touch with The Phia Group today.</span></span></span></span></p> 1271Ensuring Cost Containment Success - Member Outreach & Supporthttps://phiagroup.com/Media/Posts/PostId/297/ensuring-cost-containment-success-member-outreach-supportWebinarsWed, 31 Jul 2013 21:12:00 GMT<div class="entry"> <p>On July 31st at 1 PM EST, The Phia Group’s CEO – Attorney Adam V. Russo – and The Phia Group’s Sr. VP and General Counsel – Attorney Ron E. Peck – will address one of the most pressing issues facing our industry today – balance billing.  In particular, they will discuss what benefit plan administrators can do to assist their participants and push back against this problem.<br /> To maintain benefit program viability, employers are cracking down on excessive spending through auditing and implementing new methodologies, such as cost based reimbursement and Medicare pricing, in addition to traditional network policies.  In this new environment, participants will be thrust into the fray like never before; exposed to the threat of balance billing.</p> <p>Topics that will be discussed include, but are not limited to –</p> <p>•           When strict enforcement of the plan terms and preventing balance billing may not be harmonious goals</p> <p>•           Undertaking efforts on behalf of benefit plans to resolve disputes with providers so that participants benefit as well, compared to “patient advocacy”</p> <p>•           Providing support to participants facing balance billing by explaining why the payments were capped, describing the appeals process in detail, and providing arguments they can raise against the provider</p> </div> 297