Our Services
As your professional legal partners, we will demonstrate a significant competitive edge over other recovery groups. While our principal concentration has always been highly personalized service and excellent results obtained in a professional manner, our fee structure is also considered extremely competitive by industry standards.
Managed Care / ERISA
Payment Acceleration Pursuant to the Florida Prompt Payment Laws, Denial and Underpayment Resolution, and Refund Protection.
Our experienced Third Party representatives work under the direct supervision of our healthcare attorneys to prepare all appeals needed to exhaust administrative remedies as required pursuant to the law and your managed care contracts. Our appeals rely heavily on statutes and case law to overturn denials and resolve underpayments. Where appropriate, our attorneys will recommend to our clients legal recovery options and strategies including: litigation, arbitration, mediation and intervention. Our attorneys work closely with our clients to ensure that your claims are handled in a transparent manner with optimal results.
Early Out Trauma / Liability Accounts
Coordination of Benefits, Lien Filing, Assignment of Proceeds Enforcement, Attorney to Attorney negotiation and Lawsuit Interventions.
Our trauma and liability programs enjoy a significant success rate as they provide early identification of viable and sometimes entirely separate third party liability benefits. We handle all aspects of lien/liability protection to ensure your maximum recovery out of the settlement proceeds. We negotiate directly with the personal injury attorney and advise our client on recovery potential. As attorneys, we are in a position to evaluate the strength of the patient's case and provide an accurate assessment of the actual funds available to pay your claim. When necessary our attorneys directly intervene in the personal injury case to protect our client's interests.
RAC & MIP Appeals / ALJ Hearings
The RAC Demonstration project in Florida resulted in us assisting our hospital clients with their Third Level Appeals with the Administrative Law Judges. This appeal level focuses on an evidentiary hearing in front of an Administrative Law Judge and usually requires expert testimony. Our extensive experience in healthcare legal reimbursement led our clients to seek our representation for their ALJ RAC Appeals.
Worker's Compensation
Petitions and Complaints for Non-Payment
Worker's Compensation reimbursement continues to represent a challenge to healthcare providers. The statutory laws and administrative codes regulating Worker's Compensation reimbursement require a special skill set, and we have found that our services can be of significant value to a provider in this area. As attorneys, we are well positioned to file Petitions for Reimbursement Dispute Resolution with the State to insure maximum reimbursement for our client, and when necessary pursue further administrative relief via an Administrative Law Judge Hearing. Additionally, we employ other statutory and administrative remedies to enforce carrier compliance such as a complaint for non-payment.
Probate/Estate Claims
Accelerated payments through legal intervention
Beyond the filing of the standard Statement of Claim we will, as appropriate, initiate further legal action within the Probate proceeding to maximize reimbursement and minimize the time line for payment. Probate/Estate claims frequently represent a significant source for reimbursement. However, in order to fully protect a provider, not only is it necessary to timely file a claim with the Probate Estate, but also a provider must be appropriately positioned to respond to any "Objections to Claim" or other Pleadings which may be filed. These pleadings are usually only utilized by the Probate Estate's attorney if there are assets available to be disbursed to creditors.