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By: Pearl Walia What is ERISA in Simple Terms? ERISA, the Employee Retirement Income Security Act of 1974, is a federal law that establishes standards for most employer-sponsored retirement and health benefit plans in order to protect employees’ retirement assets. Before ERISA, employers often mishandled funds and failed to deliver promised benefits, leaving workers vulnerable to arbitrary coverage denials. In…

By: Pearl Walia Healthcare providers routinely face claim denials from payers, but not all denials are the same. Understanding their differences is critical to effectively manage revenue cycle operations. A clinical denial occurs when a payer determines that a medical service, procedure, treatment, or admission does not meet its coverage requirements. Clinical denials differ from administrative denials, which typically result…

By: Pearl Walia Changes in politics, public policy, and economic conditions continue to influence contract negotiations between healthcare payers and providers. Shifts in reimbursement legislation, regulatory requirements, Medicaid eligibility rules, and compliance obligations all affect how parties evaluate contractual provisions. As a result, payer disputes remain a persistent and significant challenge across the healthcare industry. Payers include health insurance companies…

By: Pearl Walia Revenue Cycle Management and the Current Landscape of Lost Revenue Revenue cycle management (RCM) refers to the financial process used by healthcare organizations to track and collect incoming patients, and encompasses the entire revenue lifecycle: from the initial patient scheduling to the final payment collection. Deficiencies in an organization’s RCM processes such as timeliness, accuracy and missing…

By: Pearl Walia An Income Guarantee Agreement is a type of forgivable loan provided by a hospital to a physician who is newly entering practice. Under this agreement, the hospital offers financial support to help the physician establish their practice within the community. If the physician makes the guaranteed amount under the agreement and continues to practice in the community…

By: Pearl Walia For Applied Behavior Analysis (ABA) providers–those who offer research-based behavioral therapy–receiving notice of a payer audit or payment suspension can be one of the most disruptive events their practices face. An ABA payer audit occurs when a health insurance company conducts a formal review of a provider’s claims, documentation, and billing practices to verify that its services…

Jamaal Jones connects with dental professionals, industry leaders, and colleagues at the Florida Dental Convention in Orlando. Attending events like these is a valuable opportunity to stay informed on the latest developments affecting the dental community while building meaningful relationships
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Jamaal Jones attended the World Health Expo in Miami, where healthcare leaders, innovators, and professionals came together to shape the future of the industry. As an attorney, it’s invaluable to stay connected to the legal, regulatory, and business developments impacting healthcare.
The post Jamaal Jones attends the 2026 World Health Expo at the Miami Beach Convention Center first appeared on…