Resources

Welcome to our resource library. Explore case studies, whitepapers and more.

MEMBER ADVISORIES

The Government Shutdown: What Providers Need to Know (Medicare, MA, VA, and ERISA)

I. Reduced CMS Guidance & Oversight for Medicare & Medicare Advantage Organizations (MAOs) CMS won’t be issuing many clarifications or fielding most provider questions regarding policy. Impact: Higher risk of denials…

LETTERS & STATEMENTS

ERN’s Statement to Congress

ERN Enterprises, Inc. Statement for the Record Before the U.S. House of Representatives Committee on Ways and Means Subcommittees on Health and Oversight Medicare Advantage: Past Lessons, Present Insights, Future…

DMHC UPDATES

DMHC APL Updated Advisory – Provider Feedback Requested

Dear Provider Members, Our office has been actively pursuing the resolution of claims on your behalf for post-stabilization care and services that we believe have been improperly denied by health…

ADIVSORY NOTICES

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 Full-Service Health Care Service Plans1 FROM: Sarah Ream, Chief Counsel…

ADIVSORY NOTICES

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 services that we believe have been improperly denied by health…

LETTERS & STATEMENTS

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 forms, but we approach each case with a desire to…