Representative Matters
A selection of successful outcomes achieved for our clients across various practice areas.
Payor Recoupment Defense
$2.1M Recovery
Successfully defended healthcare provider against major insurance carrier's demand for repayment of over $3 million in claims. Through strategic negotiations and aggressive advocacy, we reduced the recoupment demand by 70% and established favorable payment terms.
Compliance Program Implementation
Zero Penalties
Implemented comprehensive compliance program for multi-specialty medical group facing regulatory scrutiny. The program addressed billing practices, documentation requirements, and HIPAA compliance, resulting in clean audit findings.
Surprise Billing Arbitration
Favorable IDR Decision
Represented out-of-network provider in Independent Dispute Resolution proceeding under the No Surprises Act. Secured payment determination significantly above the insurance company's initial offer.
Contract Renegotiation
15% Rate Increase
Negotiated significant rate increases across multiple payor contracts for surgical center client, resulting in substantial annual revenue improvement while maintaining favorable contract terms.
Audit Defense
Audit Dismissed
Defended healthcare provider against government audit alleging improper billing practices. Through thorough documentation review and strategic response, achieved complete dismissal of audit findings.
Network Termination Appeal
Reinstatement Achieved
Successfully appealed insurance network termination for medical practice, securing reinstatement to network and protection of patient access and provider revenue.
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