Insurance Verification &
ERISA determination,
built into one response.
A proposal for US Anesthesia Partners — automated verification with the ERISA answer your billing team needs before the claim ever goes out the door.
One question now decides every claim.
US Anesthesia Partners operates in one of the most complex billing environments in healthcare. The growing share of self-funded employer plans, combined with state surprise billing laws, has made one question central to every claim:
"Is this plan state regulated, or federally regulated under ERISA?"
The answer changes everything — whether balance billing protections apply, which dispute pathway governs the claim, and how much revenue is recoverable. Most verification workflows surface the carrier and benefits but stop short of the ERISA determination, leaving billing teams to guess, escalate, or write off recoverable dollars.
The ERISA answer,
before it becomes a denial.
Automated insurance verification with the ERISA determination built into the response — your billing team gets the full picture before the claim goes out the door.
Electronic verification
Medical benefits verified through proprietary technology and direct carrier integrations.
ERISA determination
Returned when available — flagging plans exempt from state balance billing provisions.
Full carrier detail
Complete insurance detail from the carrier response, ready for posting and downstream workflow.
File-based intake
Upload patient records. Receive verified output back through your preferred workflow.
Service:
Insurance Verification.
Automate insurance verification and determine when a plan is exempt from balance billing provisions (ERISA).
For any Patient referred to Solutions Group, Solutions Group will exercise reasonable business efforts to:
At Provider's discretion, identify to Solutions Group — by uploading an electronic file of Patient insurance records — containing the following fields:
Tiered pricing.
Built to scale with USAP.
Tiered based on monthly transaction volume — rates decrease as volume increases.
Note: Tier volume bands and rates to be finalized based on USAP's expected monthly verification volume.
A trusted strategic
healthcare finance partner.
From proposal
to live production.
- 1
Discovery call
30 minutes to walk through current verification workflow, expected monthly volume, and integration requirements.
- 2
Tiered pricing finalized
Volume bands and per-transaction fees confirmed based on USAP's anticipated submission volume.
- 3
Agreement and onboarding
Service agreement executed, file format confirmed, and initial test batch processed within the first week.
- 4
Live production
Full verification volume flowing through Solutions Group with ERISA determinations returned in standard output.