Most providers and facilities are not familiar with the Employment Retirement Income and Securities Act which often regulates how plans are funded, created and managed. ERISA is a governing principle that holds insurance payers accountable when determining fee schedules, identifying and documenting medical appropriateness and determining what a service is worth and how it should be paid based on the level of care or location of the treating provider.

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Honu’s team of ERISA specialists helps healthcare facilities, treating providers and patients identify the most cost-effective treatment plans that will reduce out-of-pocket costs, reduce denials, reduce time spent on prior authorizations. With any services that Honu is hired to manage, providers and facilities obtain access to:

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• Coding and Fee Schedule reviews

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• SOAP Template reviews and assistance in developing documentation that utilizes LCD and NCD guidelines to improve reimbursements

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• Independent Audit Guards to prevent SIU and RAC audits

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• Real time verification of services to identify products and services that are covered

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• Prior Authorization and Claim Status Checks services

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• ERISA appeals on partially paid and/or denied claims

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• Claim settlements when insurance payers arbitrarily underpay a claim