A law firm cannot competently represent a health care provider without having experience and depth in the rules of payment and reimbursement. We are regularly involved in managed care/payor contracting with local and national insurers and HMOs on behalf of hospitals, physician-hospital organizations, and physician practice groups.
In the public reimbursement area, the Firm provides comprehensive and sophisticated reimbursement advice, planning and compliance services. All the attorneys who practice health law exclusively have considerable experience with Medicare, Medicaid, and other public payor systems. Some of our services in this area include:
• Analysis and negotiation of reimbursement and managed care contracts among institutions, professionals and third party payors
• Full-service Medicare and Medicaid reimbursement advice and planning
• Interpretation of federal, state, intermediary and carrier principles of reimbursement
• Preferred provider organizations, independent practice associations, and other managed care delivery vehicles
• Reimbursement appeals involving the PRRB, SSA, State Medical Assistance Programs, and Medicare Part B.