Maximizing Your Out-of-Network Claim Reimbursements

Over $150 Million in Payments Recovered

FOCUSED

FOCUSED

We specialize in maximizing reimbursements for out-of-network surgical claims at any stage of the claims management cycle, from preservice authorization through a multistep appeal and legal process.

QUALIFIED

QUALIFIED

We are a collaborative team of attorneys, billers, coders, and insurance specialists well versed in all surgical specialties and laser-focused on leveling the playing field between providers and payors to increase payments for providers.

EXPERIENCED

EXPERIENCED

We craft complex and innovative arguments to secure additional reimbursements from insurance companies.

RISK-FREE

RISK-FREE

We work on contingency — we don't get paid unless you get paid.

NATIONWIDE

NATIONWIDE

We serve an extraordinary, highly skilled base of accomplished surgeons across the country.

Out-of-Network Claim Reimbursements Attorneys

Out-of-network (OON) health care providers experience numerous challenges that extend beyond the operating room. Navigating the dynamic healthcare landscape, in addition to modifying practice operations to comply with new and existing regulations under federal and state laws, can take your resources away from what matters most — providing high-quality patient care. The deny, delay, and deflect tactics used by insurance companies also make it harder to obtain a fair and timely reimbursement for your services.

These challenges have increased driving practices to adjust to the many new requirements under the No Surprises Act, that went into effect January 1, 2022.

At Cohen Howard, we understand these challenges. As an experienced health care reimbursement law firm, we are focused solely on increasing revenue for OON providers from commercial insurance companies. We strive to ensure our clients are paid what is rightfully owed for services rendered. We understand the importance of a trusting provider-patient relationship and aim to indirectly help providers strengthen that bond by minimizing the financial impact of surgeries for patients.

Our Services

The Cohen Howard team has extensive experience handling a wide range of claim reimbursement issues for providers specializing in crafting prelitigation demands using substantive medical and legal arguments. In the event we are not able to secure a settlement through out prelitigation demands, we will pursue litigation as warranted. We collaborate with surgeons of all specialties: plastic and reconstructive, neurosurgery (brain, spine, nerve), general surgery, emergency and trauma, maxillofacial, vascular, transplant and thoracic surgery. 

Our Process

When you select Cohen Howard as your health care reimbursement law firm, you’ll benefit from our comprehensive process that yields results.

We’ll start by conducting a strategic claim evaluation to assess the viability of your claim portfolio and determine the best course of action for each claim by reviewing prior appeals and relevant facts of each case.  We’ll assign your case to prelitigation or litigation to pursue the appropriate reimbursement on your behalf. As skilled negotiators, we will also navigate the process of reaching a settlement with the insurance company throughout the process.

Our Team Includes the Best Lawyers for OON Surgeons

The Cohen Howard team consists of attorneys and legal professionals with extensive medical industry experience. We offer decades of combined experience in maximizing surgical claims reimbursements and have recovered tens of millions of dollars in lost revenue. We have expertise in commercial insurance, billing and coding, ERISA, state-specific health laws that govern the health care industry.

We also have an exceptional track record of maximizing revenue for our clients, including reviving aged claims where you may have given services for which your practice is no longer pursuing payment.

Contact Us to Schedule a Free Consultation Today

Learn more about what makes Cohen Howard the leading choice among law firms representing OON providers. Contact us online for more information regarding our services today. To schedule a free initial consultation with one of our lawyers, call us at 732-747-5202.

Notable Cases

Class Action v. CIGNA Corporation

Corporation et al, Case No. 3:22-cv-00769-OAW, District of Connecticut (New Haven). Date Filed: 06/10/2022.

Lawsuit v. Multiplan, Inc.

et al, Case No. 1:21-cv-02421-LLS, Southern District of New York (Foley Square). Date filed: 03/19/2021.

Class Action v. UnitedHealth Group Incorporated

Incorporated et al, Case No. 1:22-cv-10756-VEC, Southern District of New York (Foley Square). Date Filed: 12/21/2022.

Lawsuit v. Multiplan, Inc.

Inc. et al, Case No. 1:20-cv-10685-LLS, Southern District of New York (Foley Square). Date filed: 12/18/2020.

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News & Insights

The No Surprises Act: A Practical Perspective

Nearly three years after the No Surprises Act (“NSA”) became effective, there have been many surprises along the way. From the four lawsuits by the Texas Medical Association challenging the implementation of the Act, revisions to rules put forth by the Departments and several pauses along the way, the NSA has certainly had a bumpy […]

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A History of Legal Battles: The Texas Medical Association’s Multi-Lawsuit Campaign under the No Surprises Act

Last week, the U.S. Fifth Circuit Court of Appeals held that regulations implemented by the Departments of Health and Human Services, Labor, and Treasury were permitted to include “ghost rates”—contracted rates for services that were never actually provided—in calculating the Qualifying Payment Amount (QPA) under the Federal No Surprises Act (NSA). This was the last […]

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Fifth Circuit Upholds TMA II Decision

Late on Friday, August 2, the Fifth Circuit Court of Appeals upheld a crucial ruling in the Texas Medical Associations (TMA) II lawsuit, marking another substantial victory for out-of-network providers and the TMA.  This landmark decision affirms that the Departments (DOL, TREAS and HHS) do not have the authority to establish “substantive standards for the […]

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US SENATORS SUMMON MULTIPLAN’S CEO TO DISCUSS ALLEGED NEFARIOUS BUSINESS PRACTICES

On May 22, U.S. Senators Ron Wyden (D-OR), Chair of the Finance Committee and Bernie Sanders (I-VT) Chair of the Health, Education, Labor and Pensions (HELP) Committee issued a letter to Travis Dalton, CEO of MultiPlan.  Mr. Dalton is being called upon to address the findings from an investigation by a New York Times (NYT) […]

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What our clients say!