For most physician practices, insurance reimbursement is critical to financial success. Accurate billing and coding can go a long way towards helping practices avoid denials and minimize the risk of raising regulatory red flags. However, when doctors and medical groups face battles with insurers to obtain full and fair payment for insurance claims, they not only lose the revenue in question, they spend valuable time and resources attempting to collect on those claims. In addition to attempting to wrongfully avoid paying reimbursement claims, insurance companies frequently claim prior overpayments and unilaterally claw back these alleged overpayments by not paying on currently owed reimbursements, resulting in significant disruption to cash flow.
We help healthcare practices recover revenues from wrongfully denied, reduced or delayed reimbursement from insurance companies. We also assist physicians and other healthcare professionals in avoiding the appearance of impropriety, including providing a strong defense in matters involving a variety of fraud and abuse, anti-kickback and False Claims Act audits, investigations and enforcement proceedings.
Among recent matters, our lawyers have:
- Successfully prosecuted an injunction requiring an insurance company to reinstate a provider and to reimburse well over $150,000 for claims previously denied
- Negotiated multiple settlement agreements with various insurance providers regarding alleged overpayments to a practitioner