Healthcare

Reimbursement


A substantial portion of the firm's practice is dedicated to healthcare collections and related litigation, securing payment from patients, managed care companies and responsible third parties. The firm represents healthcare providers in all revenue cycle matters. Our primary goal is to ensure that hospitals and physicians receive maximum reimbursement for the services provided.

The firm relies on its experience and internal processes, including litigation, to secure denial reversal and payment of claims in the following instances:



Clinical denials.

Complex contractual denials.

Denials for lack of medical
  necessity.

Denials for lack of pre-
  authorization or notification.

Coordination of benefits.

Self-pay/Self-pay after
  insurance.

Underpayments as non-
  participating provider.

Timely filing denials.

Personal injury and third
  party liability.

Workers' compensation
   and controverted claims.

Out of network denials.

Exhaustion of benefits.

Hospital lien priority
  and lien impairment.

Employer liability.
  and failure to insure.

Reasonableness of charges.

Establishing UCR (usual,
  customary & reasonable).