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General:

• Health Insurers' Bad UCR Rate Data on Out-of Network Claims Subject to Liability   
  Description: Medical providers who have been a victim of UCR rate reductions based on bad data can increase revenue by auditing receivables and pursuing the health insurance companies that used bad data to review their claims.
• Do You Have Holes In Your Reimbursement Bucket? The “Public Option” May Make Those Holes Bigger   
  Description: Now is the time to fix any holes in your practices reimbursement bucket. Increased competition between health insurance companies may result in more aggressive reductions and denial tactics on submitted health care claims resulting in lower reimbursement to medical providers.
• Illegitimate UCR Rate Reductions Apply to All Types of Out-of-Network Medical Providers   
  Description: All types of medical providers -- from orthopedic doctors, podiatrists, dentists, psychologists, physical therapists to chiropractors -- have seen their out-of-network bills bills reduced by the application of bad UCR rate data. All medical providers are entitled to audit their claims and seek maximum payment from insurance companies.
• Wrong Fee Schedules and Other Underpayments on Managed Care Contracts Can Cripple Your Practice   
  Description: Underpayments on managed care contracts can cripple your revenue stream. Medical providers must police their rate of reimbursement on managed care contracts, stop leaks in their reimbursement bucket and pursue the revenue lost through contractual underpayments.
• Auto Insurance Companies and Worker’s Compensation Insurance Companies Continue to Be Sued Over Silent PPO Discounts on Medical Claims   
  Description: Silent PPO discounts are actively being taken by automobile and workers compensation insurers despite the fact that such plans often contain no steerage mechanisms to increase patient volume to medical providers. Silent PPO discounts on auto and workers compensation claims result in a huge loss of revenue for medical providers.
• Systematic Rescission (Cancellation) of Health Insurance Leaves Medical Providers and Patients with Unpaid Bills   
  Description: The retroactive cancellation or rescission of health insurance policies for patients with extensive medical treatment can result in huge losses of revenue for your practice. Challenging policy cancellations and demanding payment can can turn the tide on this insurance industry practice and get your practice paid.
• Why Would A Health Care Provider Want To Be A Preferred Provider? It’s All About The “Steerage.”   
  Description: Are you steered patients for each PPO that takes discounts on your bills? if you are not, your practice needs to review its PPO arrangements for potential Silent PPO discounts and to fix holes in your reimbursement bucket.

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