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ERN

Helping Providers Keep their Doors Open

Helping you keep your facility open to care

At TRAF, it’s our mission to help healthcare providers keep their doors open and ensure patient access to medically appropriate care. Since 2000, we have navigated complex payer challenges to handle the toughest denials so your team can focus on what matters most: patient cared. The best part? We work at no risk or upfront cost to you—our success is only measured when we ensure you get the revenue you deserve.

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Rise Above the Industry’s Growing Complexity

$745B

in uncompensated care provided from hospitals of all types since 2000.

1 of 3

rural hospitals are facing the possibility of shutting down.

83.2%

of appeals are overturned. 

With only 9.9% being appealed, providers could overturn seven (7) times more denials with the right appeal tools…

What this means for you

The growing burden of denied claims has severe consequences for healthcare providers. Without the right support, the future of your healthcare facility and the quality of patient care are at risk.

The Risk of Closing Your Doors Permanently:

Financial strain can lead to the shutdown of key public services or entire facilities, putting your ability to serve patients in jeopardy.

Decreased Resources and Critical Access to Care for Patients:

As resources diminish, your ability to provide essential services becomes limited, affecting patient access to timely and critical care.

Worsening Patient Outcomes:

The inability to secure adequate reimbursement forces hospitals to cut services, ultimately jeopardizing the quality of care you can provide.

Delayed or Denied Care for Patients:

Payors denying reimbursement for medically necessary services can cause treatment delays and harm patients, potentially leading to costly litigation.
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What TRAF does for your Facility

  • Intro Consultation: Start with a free, one (1) hour consultation where we’ll demonstrate how to solve your most pressing payer challenges. With 25 years of expertise in administrative laws and healthcare reimbursement, we’ll show you aspects of the claims process you may not even know exist, and how our proven methods can work for you Make Appointment Now .
  • Clinical Denial Unit: Our dedicated Clinical Denial Unit works directly with your team to proactively prevent back-end denials, addressing prospective, concurrent, and retrospective claims with strategic solutions that protect your bottom line and ensure the continuity of care.
  • Claims Representation: ERN’s team has unparalleled experience in claims representation, challenging improper denials and underpayments. With over 80% of denials being recoverable, we help you reclaim revenue by escalating unresolved claims to regulatory authorities and ensuring timely reimbursement.
  • Full Staff Training: As a TRAF member, you receive a key benefit of a complimentary two (2) hour training session each year, tailored to your facility’s specific payer challenges, guiding your team through the complexities of payer issues and equipping them with the tools and knowledge needed to navigate the claims process and improve revenue recovery.
  • Additionally, members benefit from a discounted rate on all ERN training programs, ensuring ongoing support and skill development for your team to stay ahead of industry challenges.
TRAF SUCCESS RATES

Proven Solutions through Every Denial Trend

Since 2000, we have navigated complex payer denials and resolved a wide range of issues—from clinical and technical zero pay denials, underpayments, corrective action plans, SPD coverage inclusions, public policy and legislative fights, and other types of denial issues. Our expertise enables us to quickly identify denial trends, address them proactively, and prevent further complications, ensuring your revenue cycle remains uninterrupted. By applying our deep knowledge of payer-specific rules and regulatory requirements, we help you recover the reimbursements you deserve while keeping your team ahead of the curve.
Medical necessity denials are a common roadblock for healthcare providers, where payors reject claims by labeling services as unnecessary, even though they are essential for patient care. This practice is not only frustrating but also legally questionable, as many state laws mandate that payors have qualified medical professionals review claims, ensuring decisions are made based on medical care rather than administrative or financial pressures.
Retrospective review denials occur when payors revoke treatment authorizations after services have been provided, often citing reasons such as medical necessity, pre-existing conditions, or untimely claims. However, many states have strict laws that prohibit payors from rescinding authorizations after treatment has been rendered, ensuring providers are protected when they follow the proper procedures and act in good faith.
Emergency services denials occur when payors refuse to cover necessary treatments for patients experiencing urgent medical conditions, classifying them as non-emergent despite the critical nature of the situation. These denials violate regulations that ensure emergency care must be provided immediately, without delays or the need for prior authorization, to prevent any harm to the patient’s health or well-being.
Post stabilization care refers to the essential medical treatment provided after a patient has been stabilized from an emergency condition. When a health plan fails to approve or deny post stabilization care within a required state or federal timeframe, the treatment is considered automatically authorized, and the provider is entitled to reimbursement, ensuring that patients receive continuous care without the risk of nonpayment.
Payors often deny claims based on missed filing deadlines after patient discharge, but many states have laws that protect providers from such denials when “good cause” is demonstrated, unless the payor can prove significant prejudice caused by the late filing.
Payors may deny or pend claims, claiming they never received the claim form, but many states have strict laws that presume receipt if a claim is deposited in the US postal service or delivered without rejection, and may require payors to notify providers within a set timeframe if a claim is contested or denied. These laws hold payors accountable for their claims processing and tracking, ensuring that claims are managed promptly, and any failure to comply can serve as grounds for filing a complaint with the appropriate regulatory agency.
a. Payors may request a refund for payments made on claims after conducting a retrospective review and discovering that the patient was not covered. However, laws prevent this practice, as once a treatment is authorized and provided in good faith, payors cannot rescind or modify their authorization, even if they later find discrepancies in eligibility or coverage. b. California’s Health and Safety Code § 1371.8

Trusted by Clients Nationwide

“Ed Norwood and his ERN team and suite of services are the ultimate no-brainer for every Healthcare Revenue Cycle leader... I know first-hand that Ed’s approach DELIVERS above all others. And yes, I know that there are 9 dozen other vendors who make grander claims –it has become our healthcare industry’s ultimate cliché. Ed is the real thing folks. His approach runs circles around all of them. His game-changer training is the ounce of prevention every healthcare organization needs. His clinical and non-clinical appeal win rate and time frame will bring home your dollars QUICKER and LESS COSTLY than your in-house appeals team or your preferred law firm. Better yet-- is that when you engage with Ed Norwood / ERN, your teams will quickly learn how to most effectively prevent denials, and when needed they will fight to win. That is because Ed’s perfect formulation of strategy + knowledge transforms and empowers your organization’s FRONT LINES of Patient Access, Case Management, Billing, Collections, and of course Appeals. ”

— Yaman Kahf

VP Revenue Cycle Pipeline Health

“I have worked with ERN on numerous projects over the years... and have found them to be the most excellent trainer of various levels of personnel from CFO to Billing and Admitting staff. I've sat in on a number of training sessions and I have to say - probably the best I've ever attended.”

— Debbie Esparza

VP of Payer Strategy & Relationships at CommonSpirt Health

“We learned more in one day than we had in months of trial and error. The practical knowledge and strategies ERN shared were immediately useful, and we saw improvement in our claim resolutions almost instantly.”

— AAHAM MN Gopher Chapter Member

AAHAM MN Gopher Chapter Member

“ERN's special skills changed my nephew's life. He has a rare disease and was not getting care because of insurance denial. He had no movement in any of his limbs. With rehab, we have hope of a full recovery. ”

— Julie Ward

Aunt

“I had the pleasure of hearing Ed last summer in LA. I knew at that point my organization needed him! As result, he spoke to my Case Management Directors in April at our National Symposium. I believe the time spent with my leaders is a game changer and so do my CMDs. I highly recommend Ed. He will change the landscape of your practice and provide you the tools to level the playing field with payors. He is articulate, enthusiastic and engaging. His knowledge is a MUST HAVE in your toolkit to success!”

— DeVonne Grizzle

Chief Clinical Officer at Quorum Health

“Your presentation certainly gave us much more ammunition to use against stalling or "lazy" insurance processors. While we still have not implemented all your recommendations, we are in process of make changes that we believe will result in increased revenue. We did get one $15,000 W/C payment that had been pending for almost a year paid within two weeks of using your recommended tactics in collection.”

— M. Shayegan

Shayegan Medical Administration, Inc.

“We learned more in one day than we had in months of trial and error. The practical knowledge and strategies ERN shared were immediately useful, and we saw improvement in our claim resolutions almost instantly.”

— AAHAM MN Gopher Chapter Member

Training Session Attendee

"Ed Norwood and his ERN team and suite of services are the ultimate no-brainer for every Healthcare Revenue Cycle leader. In my 15+ years of personally training under Ed, sending my Business Office staff and leaders to be trained by Ed, consulting with Ed, and accessing his dispute resolution services – I know first-hand that Ed’s approach DELIVERS above all others. And yes, I know that there are 9 dozen other vendors who make grander claims –it has become our healthcare industry’s ultimate cliché. Ed is the real thing folks. His approach runs circles around all of them. His game-changer training is the ounce of prevention every healthcare organization needs. His clinical and non-clinical appeal win rate and time frame will bring home your dollars QUICKER and LESS COSTLY than your in-house appeals team or your preferred law firm. Better yet-- is that when you engage with Ed Norwood / ERN, your teams will quickly learn how to most effectively prevent denials, and when needed they will fight to win. That is because Ed’s perfect formulation of strategy + knowledge transforms and empowers your organization’s FRONT LINES of Patient Access, Case Management, Billing, Collections, and of course Appeals. Ed is the real thing."

— Yaman Kahf

VP Revenue Cycle Pipeline Health

"I have worked with Ed on numerous projects over the years and he is one of my favorite people. I have found him to be a most excellent trainer of various levels of personnel from CFO to Billing and Admitting staff. I've sat in on a number of training sessions and I have to say - probably the best I've ever attended."

— Debbie Esparza

VP of Payer Strategy & Relationships at CommonSpirt Health

"Ed's special skills changed my nephew's life. He has a rare disease and was not getting care because of insurance denial. He had no movement in any of his limbs. With rehab, we have hope of a full recovery. Thanks, Ed."

— Julie Ward

....................................

"I had the pleasure of hearing Ed last summer in LA. I knew at that point my organization needed him! As result, he spoke to my Case Management Directors in April at our National Symposium. I believe the time spent with my leaders is a game changer and so do my CMDs.

I highly recommend Ed. He will change the landscape of your practice and provide you the tools to level the playing field with payors. He is articulate, enthusiastic and engaging. His knowledge is a MUST HAVE in your toolkit to success!"

— DeVonne Grizzle

Chief Clinical Officer at Quorum Health

"Ed is an amazing person and trainer we reached our yearly goals since acquired his services. He has inspired my staff with knowledge and self-growth. There are many organizations that provide assistance, but Ed provides 110% of his experiences and skills. I recommend his team for performance improvement and healthcare revenue cycle challenges."

— Anna Galvez Hernandez

Director of Patient Accounting AHMC HealthCare

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