The Supreme Court today ruled that the Affordable Care Act, PL111-148, in effect since September 28, 2010, including its individual mandate that virtually all Americans buy health insurance, is constitutional. Congress could use its power to regulate commerce between the states to require everyone to buy health insurance. Five Justices agreed that the penalty that someone must pay if he refuses to buy insurance is equivalent to a “tax” imposed by Congress. The Court held that the provision concerning the increase in Medicaid enrollment is constitutional as long as states would only lose new funds if they didn’t comply with the new requirements, but not lose all of their Medicaid funding.
PPACA, PL11-148, adopted ERISA claim regulations, as written, in their entirety. The new health care law in the U.S. Is based on ERISA for claims adjudication.
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Growing pains have lead us to a wonderful new building with twice the space of our old location, and room for more growth! Our new address is:
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How we serve you
ERISA law defines a healthcare denial as “anything less than 100% payment of the claim”, meaning full charges (not the PPO amount). This has the potential to deliver substantial portions of the contractuals for any claim where the commercial insurance coverage was issued by the employer (government, church, and a few other minor categories are excepted).
CRC’s industry insight, knowledge and data base of hundreds of thousands of claims can be brought to build a case file that has a very strong chance of surviving multiple strategic attacks.Continue Reading...
CRC provides a process to appeal bad debt insurance claims (going back to January 2003) under federal ERISA law as a patient advocate. We get insurance claims back for you.Continue Reading...