Major Medical Appeals & Collections
Are you an “Out-of-Network” medical provider? Very often, non-participating providers are faced with difficulty in getting paid properly for their major medical services. Constant medical appeals result in frustration and they find the insurance carrier’s decisions completely arbitrary. We can file these ERISA federal court actions which often forces the insurance company to make payments at a higher level than they were initially willing to do. We also will help you “clean up” you practices and procedures to maximize payments for future claims.
As a medical professional, getting paid by insurers has never been more frustrating nor time consuming. The insurance companies business objective is to hold onto and invest your money for as long as they can. The results in denials, requests for extensions, downcoding, “bundling”, prolonged investigations, etc…
Your billing people manage your claims and you have almost no idea of what you will get paid and if an insurer’s reimbursement rates are even in keeping with the patient’s plan. How can you maneuver these waters without even knowing the rules? Most of the PIP “shops” claim they can handle major medical claims, but few of them know this “non-arbitration” world. We concentrate our healthcare practice in representing nonpar, out-of-network, medical professionals with their major medical claims and worker’s compensation interventions. We also handle collection matters for patient who keep checks sent to them by their insurers that were intended to be used to pay for your services. For more information about our services, download our medical services brochure.
So, where do you start? You need to clean up your patient intake package and make sure all your forms give you the most advantage throughout the appeals process. You also want to be sure all appeals are being done correctly. Start by reading our FREE Report: Medical Collections & Reimbursements – 9 Things You Should Know to Increase Your Revenue.
Let’s face it. When it comes to running a successful medical practice, cash flow is 90% of the battle. This is a growing and ever evolving area of law and you should arrange for a visit with one of our partners. For a free consultation and practice evaluation, please contact us. We will analyze files and determine your possible chance of success in each case.