Health Care Reimbursement Law Services
Federal health care programs like Medicare and Medicaid pay for more health care services than any other single entity. Health care providers that bill these programs must successfully navigate their complex and constantly changing red tape. Those that don’t face costly penalties or even revocation of enrollment in the Medicare program and termination of billing privileges.
The experienced attorneys at Kennedy Attorneys & Counselors at Law work with doctors, hospitals and other health care providers from Dallas, across Texas and nationwide in all matters pertaining to reimbursement and coverage. Our highly trained attorneys work with clients on the full range of insurance payment and reimbursement issues with both government and private payers.
We consider it our business to understand the opportunities and challenges that face the industry and, more importantly, our clients’ businesses. The health care reimbursement lawyers at Kennedy Attorneys & Counselors at Law can assist health care providers with concerns such as:
- Representation at PRRB hearings or other tribunals
- Challenging allegations of overpayment, audit penalties, and recoupment actions issued by CMS, third-party administrators, insurers, and health plans
- Contesting denial of coverage, out-of-network designation, or charges outside of “usual, customary, and reasonable”
- Representation in disputes concerning agreements or contracts and deselection
At Kennedy Attorneys and Counselors, our attorneys have extensive experience with Medicare and Medicaid appeals and audits and with state enforcement agencies, such as the Texas Health and Human Services Office of Inspector General (OIG) and Texas Attorney General’s office. Our direct past experience working in government uniquely qualifies us to help you with your participation and compliance with government health care programs.
Government Payor Extrapolation Cases
We have also been successful in challenging the government’s use of extrapolation (using a small sample and applying it against a larger universe of claims) to determine overpayments. Our attorneys have particular expertise in the areas of private and public reimbursement, from individual claim negotiation through audit and overpayment litigation.