As regulators increasingly scrutinize billing practices, providers are increasingly finding that their reimbursement claims are being denied.

Providers whose claims for reimbursement have been denied do, in fact, have options. They can challenge denials through the administrative appeal process. Drawing on our detailed knowledge of Medicare Part A, Medicare Part B and Medicaid, we stand ready to assist in the process.

Our reimbursement appellate team includes attorneys familiar with Medicare Part A and Part B appeals, as well as Medicaid reimbursement; a physician and a nurse capable of dealing with clinical issues associated with privacy; and attorneys with years of experience advising hospitals, pharmacies, drug manufacturers, nursing homes, medical equipment suppliers, clinics and home health agencies, physicians, laboratories and infusion therapy providers on reimbursement issues.

Representative Matters:

• Represented numerous providers before the Provider Reimbursement Review Board
• Assisted Medicare Part B suppliers through all levels of the Part B appeals process
• Challenged Medicare regulations in federal court
• Represented hospitals, physicians, durable medical equipment suppliers and pharmacies through all levels of Medicare and Medicaid reimbursement challenges
• Assisted a major public provider in negotiating a favorable resolution in a Medicare/Medicaid overpayment matter