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Welcome to Passion for Subro & Self Funding!

The purpose of this site is to share my passion for subrogation and the self insurance industry with all of you.  My goal is that this site will become your number one destination for health insurance information.
Whether you are looking for the latest on health care reform, the most recent subrogation and reimbursement case, or want to be a self funding guru this is the place for you.  While I hope that this site serves as a great educational resource for all of you, I also hope to keep you entertained with the funny, confusing and just plain weird world of subrogation and self funding.
I would love your feedback and any newsworthy items you may have to make this site even better.

 

Recent Posts

U.S. Airways v. McCutchen – Where Are they Now?

By: Chris Aguiar, Esq. The health benefits industry can feel like a whirlwind, especially for self-funded plans.  We always seem to be running around trying to figure out
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Bidding Against Themselves: $750K Air Ambulance Claim Adventure

By: Jason Davis I have a weird claim on my desk right now involving an Air Ambulance (AA) carrier that is billing a client $750K for a flight from the east coast to the w
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Keep Hands, Arms, Legs, and Feet Inside the Ride at All Times and Remain Seated Until the Ride Comes to a Complete Stop

By: Kelly Dempsey, Esq. The last 7 years have been a wild ride and it’s not quite over yet.  As noted in many other posts and articles, the rules will be changing under t
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Health Insurance is NOT Health Care

By: Ron E Peck, Esq. The Congressional Budget Office (CBO) has provided its assessment of the American Health Care Act, and already Congressional would-be supporters of t
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If I Can Change, So Can The Average American

By: Garrick Hunt I recently celebrated my two year anniversary at The Phia Group; an organization that two years ago I didn’t know existed. In my time here, I have learne
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ACA to AHCA… A Look Back on the Past 7 Years

By: Jen McCormick, Esq. Last Monday, the House Republicans finally had their chance to offer their version of a health care bill.  The American Health Care Act, or AHCA,
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The Cost-Containment Carve-Out Compliance Conundrum

By: Jon Jablon, Esq. There is an interesting phenomenon happening in the self-funded industry today. Because medical costs are so exorbitant and arbitrary, many health pl
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Employer-sponsored Plans Should Prepare to be Taxed

By: Brady Bizarro, Esq. The latest news in the repeal and replace saga is that congressional Republicans are pushing to get a bill to the Senate by the end of this month.
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It will be my pleasure to balance bill the patient $1.3 Million…

By: Jason Davis …Is what a Hospital VP of Accounts Receivable said to me when I called to discuss a reference-based pricing (RBP) claim that was referred to The Phia Grou
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The Guilty Shall Remain Nameless – Yet I shall Shame Them… Again

By Tim Callender, Esq. In this second installment of “The Guilty Shall Remain Nameless” I can’t help but think back to an encounter I had with a walk-in clinic in Las Veg
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4 main tenets of the GOP’s ACA replacement plan

By Emily Rappleye House Republicans gathered Thursday to discuss a policy memo detailing their ACA replacement plan, according to The Washington Post. While the meeting p
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15 things to know about Stark Law

By Ayla Ellison Enacted more than two decades ago with the simple purpose of curbing physician self-referral, Stark Law has evolved into a complex set of regulations, whi
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Healthcare Need Not Be a Headache

By: Christopher Aguiar, Esq. My PCP is a great doctor, but I hate visiting him. I only live 2 minutes from his office, but somehow, my quick visits usually turn into long
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S B C, It’s as Easy as 1, 2, 3… Don’t Forget the NEW Template

By: Kelly Dempsey, Esq. The new Summary of Benefits and Coverage (SBC) template is applicable for plans that have open enrollment periods beginning on or after April 1, 2
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House G.O.P. Leaders Outline Plan to Replace Obama Health Care Act

By ROBERT PEAR and THOMAS KAPLAN WASHINGTON — House Republican leaders on Thursday presented their rank-and-file members with the outlines of their plan to replace the Af
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