In response to growing demands, ERN has revamped tools in its latest version of REVAssurance to assist our provider members.... View more
ADVISORY NOTICEHistorical Roadmap & Navigating Ambulance Provider Laws On October 10, 2023, Assembly Bill (AB) 716 (Stats. 2023, Ch. 454)... View more
MYTH: The ALJ System doesn’t work. FACT: The ALJ System DOES work. In a case study, a patient was referred to the... View more
In a recent case study, a patient was diagnosed since birth with Phenylketonuria (PKU) a rare genetic condition, an inherited... View more
One of the biggest pains we face is medical necessity denials. Despite sending proper notifications and requesting authorization on time,... View more
Myth: Any physician is allowed to determine if medical criteria was met to establish medical necessity. Fact: A physician or appropriate... View more
A large 11 hospital provider member recently submitted a complaint to ERN/TRAF against a health plan who failed to approve... View more
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 more