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U.S. Healthcare Crisis Turnaround?

U.S. A.

Drs. & Hospitals Employers

$1.0 Trillion / Year

$$$ ERISA $$$

50% Savings

The Only Company with Compliant Solutions for All of You

Rx-1  $$$$$$$$$ERISA"Health Insurance Challenges: Buyer Beware" 3-3-04
Hearing, Senate Committee on Finance
$$$$$$$$$$  Rx-2


US Supreme Court Visits
at 11:57:03 AM on Friday, November 21, 2003

New Federal Health Claims & Appeals Laws & Regulations

for 193 Million Americans

Effective 09-23-2010

©2010, Jin Zhou,

Photo of President Gerald R. Ford signing Employee Retirement Income Security Act of 1974

President Obama Signing Health Bill on 03/23/2010

President Gerald R. Ford Signing ERISA on 09/02/1974

New Webinars, Seminars & Certification Classes Announced for New Federal Health Claim Appeals Regulations on July 22, 2010 from HHS, DOL & IRS, Effective On Sept. 23, 2010 for 193 Million Americans

DOL Seal - Link to DOL Home Page



(Links to DOL) ©2010, Jin Zhou,

Patient Protection and Affordable Care Act

Statutory Laws [PDF] [PDF]



Employee Retirement Income Security Act — ERISA


Health Claims Related Information

Webinars, Seminars & Certification Classes for New Federal Health Claim Appeals Regulations - Free Webinars - New Federal Claims & Appeals Regulations, Effective Sept. 23, 2010, for 193 Million Americans Seminars - 2011 Two-day Basic ERISA Appeal Seminars - Denials and Overpayment Appeals - 2011 PPACA & ERISA Claim Specialist Certification Programs in Chicago, Illinois  Create An Appeal Department for Your Hospital or Practice (In-house, onsite ERISA Claim Specialist Certification Programs)



Breaking News


President Obama Signed Into the Law the Healthcare Legislation to Revamp Healthcare Reimbursement Laws for All Group Health Plans and Health Care Providers


The Final Health Reform Bill Has Been Signed By President Obama Into The Law Of The Land For More Than 95% Americans, As The Most Significant Changes Since Medicare Was Created 45 Years Ago. What Does Obama Healthcare Law Mean To Healthcare Providers And Health Plans? The New Federal Reimbursement Laws Protect Health Care Providers with ERISA Internal And External Appeals, Extended Disclosure And Appeal Rights, New Federal UCR Fee Centers And New Federal Simplified, Uniform Standards For Claim Processing And Appeals. The New Federal Reimbursement Laws Will Eventually Eliminate Most Managed care Abuses




ERISA CD Book: $450 Medicare CD Book: $250
Holidays' Special -  ERISA CD & Medicare CD: $560

[More info on CD Books]       [Order CD Book]


Fax Order Form (Click Here)

Click here or the CD-Picture to enter our Secured Online Order page

With New 2010 major Update


Discount for March 2005: $35


$450 ERISA CD Book

With New 2005 Update (including New ERISA Assignment Form Required for ERISA Appeals, DOL, FAQ, B2-3)

Fax Order Form (Click Here)

Click here or the CD-Picture to enter our Secured Online Order page

With New 2005 Update



Medicare CD-Book - $250

(April-May Special Discount $50)


Click Here or the CD-Picture to Enter

Our Secured Online Order page


Fax Order Form (Click Here)


Click Here to Download a Sample with Complete Table of Contents in Bookmark (pdf 1,095kb)

(Turn on Bookmarks to view Table of Contents)


While this CD book uses chiropractic specialty and Illinois as an example to illustrate Medicare coding and documentation, and it's impossible to describe every specialty and state local rules in a single book, this CD book has provided you with very specific hyperlinks to CMS/Medicare Medlearn provider specific materials in the beginning of the CD book and, in the end, a complete enclosure with all PDF files from CMS website for "Reference: Medicare Learning Network Products Catalog. This catalog provides a list of all available Medicare Learning Network products and a description of each product."


            With a complete reference guide with all pdf files downloaded from CMS and hyperlinks to provider specific Information, this CD book shall be an extreme valuable learning and practical reference tool for every specialty and location.


1.       How to establish medical necessity through correct coding and documentation for expanded coverage under New Medicare guidelines, national and local policies;

2.       How to document medical necessity in accordance with Medicare Evaluation and Management Documentation Guidelines from CMS and WPS official publications;

3.       How to prove medical necessity by appropriately ordering diagnostic tests, such as MRI, or CT scans, in accordance with local Medicare LCD to support medical necessity beyond manual palpation and x-rays;

4.       How to obtain, understand and implement CMS “1997 Documentation Guidelines for Evaluation and Management Services”;

5.       How to obtain, understand and benefit from WPS publication: “Evaluation and Management Guidebook”;

6.       How to understand CMS/Medicare initiatives in “Fighting Fraud & Abuse” by enjoying expanded coverage through medically appropriate medical care and documentation without “analysis and paralysis” avoidance of Medicare new chiropractic demo practice;

7.       How to truly understand National Correct Coding Initiative (NCCI) to avoid fraud and abuse with official CMS publications in presentation and reference guide;

8.       How to understand WPS Medicare Part B - Illinois Policy on “Magnetic Resonance Imaging”;

9.       Most importantly, learn how to obtain through Internet, understand and educate yourself for all of these through official publications from CMS and WPS;


You shall always guide your practice based on the applicable official CMS publications with precise and correct understanding of subject matter. We will teach you how to search, download and understand all of these publications and specific guidelines from CMS and WPS.




How to order


To order our products or register for seminar please follow the step by step process ....


Payment method


We accept personal and business checks, major Credit Cards including Visa, Mastercard, Discover, And American Express.




Refunds Policy


Unfortunately, due to the nature of our product on CD ROM, and on-line availability of a free downloadable Demo version of ERISA for Physicians: Healthcare ERISA Claims Denials and Appeals,

All orders are final with no returns and no refunds, except for replacement due to CD disk defect.



Click here to enter our secured online order page



Fax Order Form (click here)



Fraud Health Care Cards

"New Strike Force"

Medical Fraud Every Day?

Appeal or Re-Bill After Denial?


No Re-Billing!!!

Claim Appeal or Sentencing Appeal?

Your Choice

ERISA Not Insurance

Aetna Video Shows ERISA Patients Mistreated


"According to the video, when faced with claims for identical medical problems, Aetna separates the claims where no damages are available - those subject to the federal Employee Retirement Income Security Act, or ERISA - from non-ERISA claims, where consumers can sue.1 2"


Aetna ERISA Settlemnt with 950,000 MD's


$10,600 ERISA Claim

Recent Federal Court Ruling in a Case with $10,600 medical claim, insurance Co. refused to pay, provider made numerous demand for payment in almost one year, but no appeals filed, the court dismissed the lawsuit because provider failed to exhaust administrative remedy, as required under ERISA, by filing ERISAclaim appeals.  This situation is so popular in health-care community.



$37,350 ERISA Claim

Health-care provider alleged medical claims submitted to Aetna for reimbursement, Aetna asserted no receipt of medical claims, no written denials.  Health-care provider failed to present proof of claim submission, claim denial and ERISA claim appeals. This case was dismissed. ERISA health-care claims are handled in federal court, state law is generally not applicable.


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