Texas Out-of-network Arbitration (SB 1264) vs Federal IDR: Which Applies to Your Claim
State-regulated fully insured plans, the Employees Retirement System of Texas, and the Teacher Retirement System of Texas generally use Texas SB 1264, […]
Is My Claim Eligible for Federal IDR? Self-funded ERISA vs Fully Insured Plans and When State Law Applies
Is your claim eligible for federal IDR? For many out-of-network claims under private-employer plans, yes, including claims under self-funded ERISA plans, provided […]
Out-of-network Assistant Surgeons and Orthopedic Surgeons: Recovering Underpaid Claims Under the No Surprises Act
An assistant-surgeon claim may be paid, but the allowance can still fall short of the work documented in the operative report. For […]