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Common concerns about erisa claims

Filing an ERISA claim may seem a straightforward process at first, but it is important that every detail of these claims receives adequate attention. The role of physicians in such a process is crucial, as insurance companies rely heavily on accounts made by medical professionals. Knowing the ins and outs of these claims can help Texas patients avoid issues in the future and, most importantly, ensure the acceptance of filed claims. 

ERISA claims often invite more questions than answers. ModernMedicine Network, a resource for news, content and programs in the health industry, speculates on the ways this federal law initially sought to help employees; however, there are many differing views on ERISA's impact on the working world. ModernMedicine casts a doubtful shadow on the limitations this law can place on employee plans, noting that nothing but the amount of the benefit is applicable to an ERISA claim. ERISA applies when a patient has an employee-provided plan, and that plan denies a claim. At the time of the article in 2013, ModernMedicine anticipated the slow-pay laws in the works from various states regarding the timing of payments.

The United States Department of Labor clarifies some of the confusion that can surround this law. Simply put, the U.S. Department of Labor issues rules regarding the processing of benefit claims, the timeframe in which one can file a claim and certain rights if a claim is denied. To better understand individual ERISA coverage, the Department of Labor directs employees to their summary plan description, which contains details about provided benefits. The brochure also contains responsibilties under ERISA. For additional information, the Department refers to the Summary of Benefits and Coverage, a more concise summary of available benefits and other information involving costs for coverage.   

  

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