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Posts Tagged ‘ERISA’

Ask a Lien Professional – ERISA Subrogation & Reform

Wednesday, March 31st, 2010

QUESTION: 

Will the new Health Care Reform Law have any affect on ERISA plans and subrogation in the future? – FL Attorney 

ANSWER:

Right now there are many unknown variables regarding ERISA plans and the new Patient Protection and Affordable Care Act of 2010 that was signed into law on March 23, 2010.  What we do know is that health insurance practices, including Subrogation and Recovery will experience changes over the next few years. 

The Employee Retirement Income Security Act of 1974 (ERISA) is a federal law that sets minimum standards for most voluntarily established pension and health plans in private industry to provide protection for individuals in these plans (US Department of Labor, www.dol.gov).  Employer provided health plans are governed by ERISA, which also loosely defines their right of recovery, allowing for “appropriate equitable relief” (29 USC 1132(a)(3)).  Plans that are Read the rest of this entry »

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LSS Project and Multi-Case Resolution Program

Tuesday, March 30th, 2010

Lien Settlement Solutions is now equipped to handle Multiple Claimant Projects! 

In settlements like Asbestos Exposure/Mesothelioma diagnoses, Pharmaceutical Liability, Environmental Exposure, or Single Incident Personal Injury cases (among others), LSS can assist with the case management and compliance of files that may have an obligation to an insurer or provider.  We are able to create a resolution package for projects ranging from 5 – 1,000+individual claimants or beneficiaries.  From pre-screening, intake, reporting and resolution we have developed a process that will save your firm the time and headache of resolving multiple claims with several different potential lien holders. 

Our Project Resolution Program includes:

  • Pre-Screening – Before cases are submitted for resolution, we will review all related exposure, benefit eligibility, and billing records to verify the need for resolution services in an individual case.  For cases submitted for Asbestos Lien Resolution services, we will determine if the case meets Medicare’s provision for recovery of cases with exposure on or after December 5, 1980. Read the rest of this entry »

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Ask A Lien Professional: Recovery Contractors

Thursday, February 18th, 2010
Question:

I have a case that has a private insurance lien. I sent in a notice to the insurer, but got a response from another company.  What do I do with this? - Orlando Attorney 

Answer: 

 When resolving a possible lien with a private insurer, it is important to know who the involved parties are, and their role in the resolution of a case.  You have received a response from a “Recovery Contractor” which is a separate company hired by the insurer to address all subrogation and recovery issues on their behalf.  Recovery contractors have the authority to initiate collection activity against the insured, to provide information about the claims included in the lien, and act as the liaison between the lien holder and the insured in matters of lien negotiation.  In order to get the best results from a recovery contractor, there are three things you should know.  

 
 1. They want to recover as much as possible – even if they aren’t entitled to it!
Recovery contractors are a lot like collection agencies.  They want to recover as much as possible, because in some cases, it adds to their bottom line.  The problem with that is, the amount that is submitted for payment  is not always the amount that the claimant should have to pay.  It is important to audit the claims included in the lien to be sure that they are all related to the compensable injury.  Even more important is the evaluation of the plan language and plan type before making any offers or payments. 

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The ABCs of Lien Resolution

Wednesday, September 23rd, 2009

alphabet-chalkboard

 

Quick tips that can move your settlement to the Head of the Class!

A – Allocation:  When in the process of negotiating a settlement and determining the allocation of proceeds, be mindful of any outstanding lien obligations.  Some plans may have a right to recover from the full value of the settlement if an allocation does not protect their interest.

B – Bargaining with a provider or recovery agent can be worthwhile if there is a clear understanding of the strength or weakness of their right of recovery.  Make them an offer they can’t refuse!

C – Call! Regular communication is necessary, especially when resolving with Medicare, Mediaid or the Military Health Plans.  Remember, the squeaky wheel gets the oil!

D – Delegate:  When the task of Lien Resolution becomes to overwhelming, delegate this aspect of case management to the PROs!  Lien Settlement Solutions offers programs that meet all of your lien resolution needs.  Call us at (877)907- LIEN to speak to one of our representatives! Read the rest of this entry »

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