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Health Care

Kristin K. Kline is a skilled healthcare law attorney with extensive experience in the many issues facing both patients and healthcare providers, including:

Health Care Reimbursement Insurance Recovery

UTILIZING STATUTORY LANGUAGE AND CASE LAW VERDICTS WHEN WRITING INSURANCE APPEALS MAXIMIZES YOUR REIMBURSEMENTS:

Within the last 6 years Congress has passed many new prompt pay laws that greatly affect the likelihood of whether or not your claims will be processed for payment or denied. House Bill 610, passed in 1999, was originally designed to expedite HMO and insurance company payment of “clean claims” submitted by physicians and providers. Because providers continued to have concerns that claims were not being paid in a timely manner, Senate Bill 418, which the legislature passed in 2003, made changes to the law to make claims filing and prompt payment processes streamlined, standardized, and more efficient.

Understanding the distinctions between House Bill 610 and Senate Bill 418 and their key provisions increase the likelihood of getting your claim paid. Once you place a claim with us, we will ensure that the insurance company adheres to these rules when reviewing your claim for reconsideration. Unfortunately, the prompt payment language does not regulate self-funded (ERISA) benefit plans. ERISA is a federal statute that generally preempts state prompt pay laws. However, despite these preemptions, our firm has successfully persuaded self- funded plans to reconsider their original denial and reprocess these types of claims for payment too.

We receive positive results from our insurance appeals because we have the capability of getting the insurance companies to overturn their original denial by incorporating State and Federal laws in addition to successful case law verdicts in our appeals.

The key advantages of placing these types of accounts with us:

Utilizing State and Federal laws increases the likelihood of getting your claim reconsider for payment.
Insurance companies are more likely to reconsider a claim once legal intervention is in place.
We monitor the progression of our appeal with continous follow up with the insurance companies.
We will provide monthly status reports advising you of the progress of the claim.

If you have healthcare claims that have been unjustly denied, take this opportunity to reclaim the benefits that you may be entitled to. Call us to discuss how we can help you recover payment for your denied health care claims.