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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

Overpayment Success Story: Dialysis Claim

By: Michael Branco A dialysis claim was adjudicated at the regular out-of-network rate instead of the dialysis carve-out rate of 130% of Medicare. After unsuccessful atte
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Beware the Network!

By: Jennifer McCormick, Esq. Self-funded employers should be careful when selecting networks. In some cases,  low discounts, anti-audit clauses, unseen provider agreement
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The Details Matter

By: Brady Bizarro, Esq. Employers face many, many regulatory burdens. There is an ever-increasing number of federal regulations to abide by (although that might change),
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A Canadian Pays Cash for Care – Part One

By: Jason Davis I have personally experimented with paying cash for healthcare. I had sustained a rather nasty cyst/lesion on my chin (basketball accident – I named it Je
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Mental Health Parity and Claim Negotiation

By: Jon Jablon, Esq. When choosing claims to have negotiated, don’t worry about mental health parity. While it’s an important set of laws, it primarily protec
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Call Me Corny…

By: Ron Peck, Esq. So; call me corny, but as I watched my favorite football team miraculously pull forth victory from the jaws of despair, I was inspired.  No – I wasn’t
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10 things to know about athenahealth

By Jessica Kim Cohen Here are 10 things to know about Watertown, Mass.-based athenahealth, one of the largest publicly traded companies in the world providing medical rec
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As language shifts to ACA ‘repair,’ Pence reaffirms commitment to ‘repeal and replace’

By Tamara Rosin Although some Republican lawmakers have begun to discuss a more tempered goal of “repairing” the ACA instead of tearing it down, Vice Presiden
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I Have a Bridge to Sell You …

By: Chris Aguiar, Esq. Read this article this morning – https://www.nytimes.com/2017/01/29/health/obamacare-affordable-care-act-lifesaver-burden-voices.html?_r=1 Po
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ACA Section 1557 – Federal Court Injunctions, Executive Orders, Repeal/Replace, Oh my!

By: Kelly Dempsey, Esq. A federal court injunction related to 1557 was granted on 12/31/16, temporarily stopping portions of the rule—discrimination on the basis of gende
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Massachusetts Braces for ACA Repeal

By: Brady Bizarro, Esq. This morning, I had the pleasure of attending a conference held by the Massachusetts Association of Health Plans on “Examining the Effect of
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Enough to be Dangerous

By: Ron Peck, Esq. In my time, I’ve encountered opposition that admits to knowing nothing about the topic, and seeks to engage me in common sense discussion; and, opposit
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Change Often Starts with a Conversation

By: Garrick Hunt My wife, quite literally, has no idea what I do for a living. When friends and family ask, she normally replies, “…he does something with sub
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An Unlikely Recovery

By: Michael Branco The Phia Group’s overpayment specialists received two claims – same provider, same patient – totaling over $760,000. The reason for the refund was that
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Phia Group Consulting Is Always Ready to Help

By: Jennifer McCormick, Esq. Phia is continuously searching for ways to evolve and improve the plan drafting process for our clients, including notification of key compli
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