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Understanding ERISA Law: How to Appeal ERISA Claims

Understanding ERISA Law: How to Appeal ERISA Claims

A large number of questions I receive deal with appealing denied insurance claims and these denials cause most doctors headaches. When a claim has been denied because of medical necessity or because a service is not covered, an important step in the appeals process is to determine if the patient’s plan is a self-funded ERISA plan.

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Shoulder Pain

Shoulder Pain

The shoulder is responsible for approximately 16% of all primary care musculoskeletal visits. (1) Many of these patients exhibit an often overlooked, altered scapular position and motion pattern called, “Scapular dyskinesis” (i.e. “winging”) (2,3) In order for clinicians to properly manage shoulder pain, including rotator cuff problems, they must first be able to recognize and treat scapular dyskinesis.

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