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

Federal Texas Court Orders Government Agencies to Vacate NSA Fee Increase and Batching Rule

As previously reported, the Texas Medical Association (TMA) filed a series of lawsuits over the rules implemented by the Departments under the No Surprises Act. On August 3, 2023, Judge Kernodle, US District Court of Eastern Texas, ruled in favor of the TMA vacating certain portions of the No Surprises Act final rule. This lawsuit […]

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Federal Government Appeals No Surprises Act (NSA) TMA II Decision Concerning the QPA

In a recent development surrounding the implementation of the No Surprises Act (NSA), the United States Department of Justice (DOJ) has filed an appellate brief to appeal the Texas Medical Association (TMA) II decision. This decision vacated certain portions of the Interim Final Rules Part II which were determined to continue to prioritize the qualifying […]

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NJ DOBI Issued Bulletin No. 23-05, June 28, 2023, Non-Discriminatory Coverage for Transgender Individuals

In an effort to promote equal access to healthcare and coverage, the New Jersey Department of Banking and Insurance has published Bulletin No. 23-05 following Governor Murphy’s issuance of Executive Order 326, “Protecting Gender-Affirming Health Care in New Jersey”. This bulletin serves as a reminder to all insurance companies authorized to issue health benefits plans, […]

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Court Decision in TMA Lawsuit Good News for Providers

This week, a Texas US Federal District Court granted a summary judgement in favor of the Texas Medical Association (TMA) setting aside and vacating the latest qualifying payment amount (QPA) Rule as violating the No Surprises Act (NSA).  The Court acknowledged, “although the Departments have abandoned the ‘rebuttable presumption’ term, they have not relinquished their […]

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What our clients say!