Jul. 2, 2024
ADVISORY NOTICE: AUTHORIZATION REQUESTS FOR POST-STABILIZATION CARE
Dear Provider Members, Our office has been actively pursuing the resolution of claims on your behalf for post-stabilization care and... View Article
Categories for Press Releases
Jul. 2, 2024
APL 24-012 – Single Point of Contact for Hospitals to Request Authorization for Poststabilization Care
FROM THE OFFICE OF THE CALIFORNIA DEPARTMENT OF MANAGED HEALTH CARE: ALL PLAN LETTER DATE: June 25, 2024 TO: All... View Article
Jan. 31, 2024
Letter to the OIG on “Non-Interference” Policy
Esteemed Provider Members, Here at ERN/TRAF, we advocate every day for you, your providers, and patients. Our advocacy takes many... View Article
Oct. 25, 2023
DHMC Advises Requirements for Requesting Authorization for Post-Stabilization Care
Dear Provider Members, Our office has been actively pursuing the resolution of claims on your behalf for post-stabilization care we... View Article
Jun. 29, 2022
Obtaining Authorization While Patient Is In House
MYTH: MA Plans are not required to respond to an inpatient authorization request. FACT: MA Plans ARE required to respond to an inpatient authorization... View Article
Apr. 6, 2019
Community Rallies Around Yorba Linda Teen in Need of Operation
ERN in the news! This morning, I saw this piece aired by Channel 5 of a young boy we successfully... View Article
Dec. 4, 2018
How to Challenge Improper Denials of Emergency and Post-Stabilization Services
INTRODUCTION As a provider in the acute medical setting, you have undoubtedly experienced the difficulty in obtaining prompt reimbursement for... View Article
Feb. 27, 2018
Can an HMO make a medical decision without looking at medical records?
Sometimes you are the only thing that stands between the single crushing blow of HMO and a patient or provider.... View Article
Dec. 8, 2017
24 Hour UM Access
Hello, you have reached the UM Department. We are open Monday through Friday, 8 a.m. to 5 p.m. Please leave... View Article
Sep. 23, 2016
CalPERS DENIES AUTHORIZED MEDICAL CARE FOR DECEASED MEMBER
Justice will not be served until those who are unaffected are as outraged as those who are. – Benjamin Franklin... View Article