by Jason Anderson | Jul 21, 2020 | Denied Claim Appeals, Denied Claims Litigation, General Litigation, Healthcare Reimbursement, Hospital Reimbursement, Managed Care - General, Managed Care Reimbursement, Medicaid Reimbursement
Why litigation may be the best option in Maryland to recover denied claims Since its inception in 1997, Maryland’s HealthChoice program has expanded to provide healthcare coverage to a majority of Maryland’s Medical Assistance (“Medicaid) recipients. Through its...
by Gustavo Matheus | Aug 1, 2019 | Appeals and Denials, Denied Claim Appeals, Denied Claims Litigation, Healthcare Appeals, Healthcare Reimbursement, Hospital Reimbursement, Managed Care - General, Managed Care Reimbursement, Payer Reimbursement, Provider Denials
Utilization management requirements often run counter to the medical standard of care When representing providers, I have noticed an unfortunate trend in recent years. Utilization management (UM) is encroaching upon the profession of medicine. With utilization...
by Karen Kizer | Jan 28, 2014 | Appeals and Denials, Denied Claims Litigation, Healthcare Reimbursement
Solving the Problem of Utilization Review and Hospital Payment Denials Today’s health insurance plans—whether health maintenance organizations or traditional indemnity plans—must reimburse hospital, physician and other provider services only if they are deemed...
