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HEALTHCARE PROVIDER THIRD-PARTY REIMBURSEMENT CLAIMS & LAWSUITS

HEALTHCARE PROVIDER THIRD-PARTY REIMBURSEMENT CLAIMS & LAWSUITS

If you are a medical facility, doctor or other healthcare provider who bills and seeks third-party reimbursement from commercial health insurance companies like United Healthcare (Optum) the Blue Cross Blue Shield Companies, Aetna, and CIGNA, for example, you are most likely familiar with their audit, review, and reimbursement process.  Most healthcare providers who have had an experience with those processes had a very unpleasant experience.

The post-payment review process by these insurance companies is an extraordinarily unpleasant surprise to healthcare providers and appears to be—most likely is—a corporate engineered money grab. When the healthcare services you and your practice have been providing, and were paid for, are now being questioned after the fact, it is angering, stressful and unnerving. In addition, these health insurance companies often stop paying any of your reimbursement claims during the process, or put you on a review protocol that makes it extraordinarily difficult to get your valid claims reimbursed and to operate your business from an ongoing cash flow and profitability perspective.

At Schwartz, Conroy & Hack, we have been managing our clients’ post payment review audit and reimbursement claims for many years, successfully resolving them, and typically without the need for a lawsuit. Our success comes in understanding how your healthcare practice is managed, how your services are delivered, and understanding the details concerning your billing, collection, and documentation process. If a lawsuit is necessary, we are fully equipped to and have, successfully, litigated these claims.

Our successful representation of your healthcare practice comes from our understanding of your process and the insurance company process. This allows us to achieve an efficient and successful result for you, so you can focus on your health care practice.