Healthcare Appeals

Anderson & Quinn helps healthcare providers successfully manage difficult appeals. We understand the complex laws and regulations that challenge the healthcare industry. Our attorneys are immersed in the tough issues providers face every day. We stay abreast of industry standards, regulations and new methods of tackling healthcare reimbursement issues.

Commercial Payer/Internal Appeals
 – Medical necessity
 – Improper discounts
 – Eligibility issues
 – Coordination of benefits and Timely filing denials
 – Non-covered services or Experimental treatment denials
 – Pre-certification penalties
 – Pre-existing conditions
 – Usual & customary rate denials
 – Delay in services denials
 – Payment rescission and refund requests/offsets

Government/Administrative appeals
 – “Fee for Service” Medicare
 – “Fee for Service” Medicaid
 – U.S. Dept. of Labor
 – Workers’ Compensation (Federal and State)
 – Recovery Audit Contractor (RAC) defense
– Medicare Appeals Council (MAC) appeals

Automobile liability subrogation

ERISA and third-party administrator negotiation

Anderson & Quinn Healthcare Attorneys

Rob P. Scanlon

Rob P. Scanlon

Managing Member

Gustavo E.I. Matheus

Gustavo E.I. Matheus


Jason C. Anderson

Jason C. Anderson


From the blog

Confusion in Pre-Certification/Pre-Authorization Denials

Insurance standardized codes can cause confusion for healthcare providers. In 2008, Medicare updated its policy to require contractors to employ standardize codes in paper and electronic Remittance Advice (RA) forms. Derived from Health Insurance Portability and...

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