ACA Compliance

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Affordable Care Act (ACA) Compliance

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The Affordable Care Act first came into implementation in 2010 as a way for more Americans to gain access to the medical care they needed but could not always pay for. The USA has divided the responsibility of healthcare funding among various insurers here and throughout the country.

As a result, there is a complex mix of federal and state law that applies to how insurers provide healthcare coverage and, more importantly, how they manage certain practices, such as handling claims, reimbursements, copay, and other aspects of medical coverage. On top of this, these ACA regulations aren’t static. As time passes and new administrations come into place at both state and federal levels, changes or amendments to the ACA are inevitable. These changes, in turn, can affect both clients and providers with regard to healthcare coverage. This is where IIS Benefit Administrators steps in to help.

Compliance Is Essential

Despite the numerous insurers and other carriers operating in their own way, and the offering of many different types of coverage from standard medical group plans to voluntary products such as dental or optical, one thing remains the same. There must always be compliance in all of these health plans with the ACA regulations for workers to receive their coverage.

The Electronic Health Record (ERH), for example, requires certain types of information must, by law, be included in any medical diagnosis and treatment if there is going to be a claim made for medical coverage. In the same way, specific protocols must be observed by the insurers themselves when they file and handle claims, so as to ensure a clear “paper trail” that is trackable, transparent and verifiable, all while protecting the privacy of patients.

IIS Provides Solutions

IIS Benefit Administrators has had decades of experience working in the health insurance industry and has been informed and aware of ACA regulations right from the inception of the act as a law. Because of this, and our experience working as a third-party administrator, as well as a partner with brokers, IIS Benefit Administrators have a comprehensive understanding of ACA protocols.

When you come to IIS Benefit Administrators, you get all the help, guidance, and information you need to learn how to follow ACA protocols and remain compliant with ACA regulations. There is a lot to take in, and it touches almost all aspects of the health care coverage industry, so it’s crucial you remain familiar and compliant with these rules. Failing to comply with ACA regulations can mean the difference between a trouble-free medical claim, and a worker finding out that a claim was rejected, forcing either an investigation to find out what happened, or accepting the error and paying out of pocket.

Don’t take any chances when it comes to managing health coverage claims and administration. IIS Benefit Administrators has the experience and familiarity with ACA regulations to ensure that every interaction is properly documented and ready for approval by ACA standards. If you’d like to know more, contact us.