With a primary focus on No Surprises Act (“NSA”) arbitration, Gottlieb and Greenspan represents medical providers throughout the country in reimbursement disputes with health insurance carriers.
Our clients include surgeons of every discipline, anesthesiologists, hospital systems, medical billing companies, and physician assistants among others.
In addition, we routinely advise our clients on streamlining reimbursement, compliance with state and federal regulations, and defending against insurance recoupment attempts.
THE NSA
The No Surprises Act (NSA) is a federal law designed to protect patients from unexpected medical bills when they receive out-of-network care in certain situations. Partnering with a trusted law firm like Gottlieb & Greenspan enables out-of-network medical providers to truly maximize NSA reimbursement.
Click here to learn more about our NSA services.
OUT-OF-NETWORK ERISA LITIGATION
Because most health insurance plans are employer-based, they are often governed by the federal law known as ERISA. This means that for many insurance disputes, the only way to properly fight an insurance underpayment or denial is through an ERISA lawsuit, involving many of the complexities that accompany federal litigation.
We do not shy away from that complexity—we embrace it. Our attorneys have filed and settled hundreds of ERISA actions. We continuously stay abreast of the latest and often meritless defenses utilized by carriers, and we employ creative solutions to bring your case to a resolution.
IN-NETWORK ARBITRATION AND LITIGATION
In-network providers are not immune from improper insurance denials and underpayments. As a “PAR” provider, you are a contractual partner with the carrier. Thus, any infringement on your bargained-for rights ought to be contested and we excel at doing just that.
Whether via arbitration pursuant to a clause in the contract, or general breach of contract litigation, we are uniquely qualified to resolve in-network payment disputes.
RECOUPMENT ACTIONS
Just because an insurance carrier says they overpaid you, that does not make it so. In our experience, most overpayment assertions are predicated on dubious grounds. We have a strong record of successfully disputing overpayment and recoupment efforts initiated by insurance carriers. In fact, we have often recovered additional money for our clients in cases where the carriers originally sought recoupment.
MEDICAL BILLING COMPLIANCE AND GUIDANCE
While the NSA is a federal law that applies nationwide, over 30 states have passed their own surprise billing laws resulting in a tangled web of state and federal regulations.
These laws and regulations vary depending on medical circumstances, date of service, and type of insurance plan, among other things. We guide our clients to confidently comply with these new and often confusing rules, and further provide expert advice to maximize their reimbursement.