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Provider Alert - Vol. 1 - Seeking Full and Fair Payment for Providers

Seeking Full and Fair Payment for Providers

When a patient receives emergency room services, and the patient’s health care plan subsequently refuses to pay the entire bill, can the emergency service provider directly recover more from the same health care plan? The answer is Yes. Doctors now have standing to sue in California for low reimbursement. Van Parys Law typically recovers 100% of the doctors’ billed charges. There is no fee unless you win.

For physicians, the costs of running an independent practice is increasing while medical reimbursements are decreasing.

Obtaining the Compensation You Deserve

The problem is the prevalence of third-party payment systems and the regulatory structure. Van Parys has pioneered the area of 100% provider reimbursement litigation and fighting around the third-party payment schemes.

We counsel our clients on how to handle third-party claims submissions but providers need to take it to the next step, litigation. The steps are: (1) patient in-take, (2) discharge, (3) appeal, and (4) lawsuit. Don’t stop at the appeal process. Don’t settle on recovering 80%-85% of your bills. We stress the importance of meticulous documentation, both clinical and administrative, and strict adherence to the administrative appeal process. The final step is litigation which typically recovers three times more than the appeal process. The appeal process is important to show the judge ‘exhaustion’ of all administrative paths before the state superior court. You need an experienced and aggressive litigator who will get all your money fast.

Van Parys

We represent practitioners, hospitals, nursing homes and practice groups, as well as medical associations and others to recover lost revenues from wrongful delay and/or denial by insurance companies. The fact is that many practitioners and entities are finding that they must argue with insurance companies to get proper payment and reimbursement for claims. Don’t argue and waste time, litigate instead. Wrongful delay, denial or reduction in reimbursement is illegal, and our billing and reimbursement attorneys can assist you in recovering those payments.


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