You Operate. We Recover.
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.
News & Insights
News
BCBS $2.8B Anti-Trust Settlement — How to File
A proposed $2.8 billion settlement has been reached between the Blue Cross Blue Shield Association (“BCBSA”) and healthcare providers. It resolves claims that BCBSA violated antitrust laws by dividing service areas and fixing prices. The settlement is complex. The settlement website can be found at: https://www.bcbsprovidersettlement.com/Home/Index. That website explains the settlement and provides instructions for filing a claim. […]
18
Feb
Surprise Bill
Legal Motion Filed to Rehear Fifth Circuit’s Decision on Inclusion of Ghost Rates in NSA QPA Calculation
The No Surprises Act (NSA), enacted in December 2020, was designed to protect patients from unexpected medical bills for emergency services and certain non-emergency services provided by out-of-network providers. A central component of the NSA is the Qualified Payment Amount (QPA), which serves as a benchmark and is one of several factors for determining reimbursement […]
27
Dec
Surprise Bill
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 […]
04
Dec
Surprise Bill
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 […]
04
Nov
What our clients say!
"We gave Cohen Howard a very difficult hospital claim to work on. The claim had already been handled internally, by an outside lawyer and by a collection company. When Cohen Howard received the claim, it was nearly 3 years old and we had not received any payment. Cohen Howard was able to recover an $89,000 payment from the insurance company in less than 6 months’ time for us. Great job!"
Cappy Taylor
"After a decade of practice I was hoping that a firm like Cohen Howard actually existed. They represent a group with the experience, deep knowledge, and tenacity to succeed in the complex world of medical reimbursements. Within this environment they have produced excellent financial results on a substantial number of my cases. Their professionalism and communication make for an unparalleled service."
Ross Cooperman, MD
"Cohen Howard is a truly unique group who has a profound understanding in the medical insurance industry. I am very pleased with Leslie Howard and her professionalism. Her staff is also very knowledgeable, detail oriented and quick to respond to all questions that arise. I am very impressed with their consistent ability to help increase my practice's out of network claims revenue. I would highly recommend them!"
Tzvi Small, MD, FACS
"Leslie Howard and her staff have helped us find revenue on our out-network-claims that we never knew existed. Fantastic job! Whatever you're doing, it's working."
David L. Abramson, MD
"Cohen Howard's team of professionals have been amazing partners in increasing our out-of-network claims revenue. Their professionalism and attention to detail are remarkable. We gave them some amazingly difficult claims to work on and they were able to successfully recover funds that we had basically written off. Thank you."
Sean Bidic, MD, MFA, FAAP, FACS
"I have been working with Cohen Howard for years now and they have been able to retrieve several hundreds of thousands of lost revenue. They are extremely knowledgeable in the field and I recommend them with high praise!"
Steven Priolo, MD, FACS
