As a healthcare provider, you want and need prompt reimbursement from Medicare, Medicaid and other payors. We help you obtain Medicare and Medicaid provider status. Through audits and claims evaluations, and denial and exception reviews, we also help you secure reimbursement from third-party payors by challenging their denials of your legitimate claims. Our attorneys have in-depth experience presenting provider claims to the Provider Reimbursement Review Board and Medicaid rate agencies.
We have successfully challenged defects in the State Plan Amendment process and represented healthcare organizations in Boren Amendment litigation. If you are audited by the government or third-party payors, we can draw on our vast experience defending other providers in the audit process. Our services include negotiating contractual relationships, dealing with federal and state administrative agencies, providing advice about patient transfer and "dumping" issues, and keeping you informed of pending legislation.
Representation of Third-Party Payors
We represent third-party payors, including health insurers, Medicare Advantage plans, third-party administrators and self-funded ERISA plans in structuring and advising relationships with healthcare providers. We also represent payors in disputes with healthcare providers, including class actions.