Tuesday, February 20th 11am – 3pm
Venue: Gatton College of Business and Economics
Wednesday, February 21st 11am – 3pm
Venue: Gatton College of Business and Economics
Wednesday, February 21st 2:00pm – 5:30pm
Venue: University Club
Tuesday, February 27th 1:30pm – 5:30pm
Venue: Lexington Center
Recovery of COB overpayments requires a deep knowledge of the statutes and regulations affecting claims payment transactions and laws vary greatly from state to state. Because The Rawlings Group provides recovery services in every state, our COB legal team developed this comprehensive reference guide to consult when reviewing claim investigations.
Each state’s insurance statutes and regulations contained herein are consistently monitored, researched and updated. This reference manual will aid in the management, administration and recovery of coordination of benefits claims. It can be used by the Law Department and COB divisions of Health Insurance Carriers, as well as third-party administrators (TPAs).
The National Coordination of Benefits Law Manual can be purchased on Amazon using the following link: https://www.amazon.com/dp/0991391578
Until the 1980s, it was rare for a health insurer to rely on subrogation and reimbursement as a significant cost savings application. However, identification of potential recovery cases has been dramatically improved through the use of systems detection methods such as the programs developed by The Rawlings Company LLC. These automated systems, combined with increased personal injury claims and economic factors, make subrogation and reimbursement necessary parts of any cost savings program. What was once a relatively dormant area of law has developed into a dynamic process in which the health plan must work to maintain its right to recover benefits when there is another source (such as a third party or other carrier) that has a primary obligation for paying those benefits.
This law manual can be used by the Law Department and Subrogation Divisions of Health Benefit Indemnity Companies, HMO’s, and PPO’s, as well as third-party administrators (TPAs) and law school libraries. Further, this handbook can be used as a convenient reference for issues that now frequently arise with subrogation and reimbursement claims and will enhance the management, administration, and recovery of such claims.
The 2018 edition of this manual updates changes to the law in all 50 states and the District of Columbia. Commentary and relevant case law pertaining to the Federal Employees Health Benefits Act and Medicare are found in the “Introduction” section of this manual. Information pertaining to ERISA follows. Here the reader will find selected case law pertaining to the preemption of state laws regarding subrogation, any made whole rule and the common fund doctrine. The final section of the manual examines state laws relevant to subrogation and reimbursement on a state-by-state basis. As the leading compilation of its kind, this manual is the perfect handbook to assist in the management, administration, and recovery of health plan subrogation and reimbursement claims.
The 22nd Edition is available for purchase on Amazon.com through the following link: https://www.amazon.com/dp/0991391586
