by Gustavo Matheus | Jun 13, 2022 | Insurance Coverage Disputes
On April 27, 2022, the Office of the Inspector General for the U.S. Department of Health and Human Services (“OIG”) released a report finding that Medicare Advantage Organizations (“MAOs”) are issuing unnecessary denials resulting in delayed care for patients and...
by Hailey Groover | Mar 2, 2022 | Insurance Coverage Disputes
By: Hailey Groover, Legal Assistant Conflicts in Coordination of Benefits Under Maryland Insurance Article § 15-1008 Healthcare providers occasionally run into situations where a patient will have coverage under two health plans. Ironically, because of...
by Philip Wright | Sep 8, 2019 | General Litigation, Insurance Coverage Disputes
Debido a la antigüedad de la infraestructura en Maryland, este tipo de rupturas de tuberías ocurren con mayor frecuencia. Y pueden causar grandes dolores de cabeza. Además de interrumpir el tráfico, a menudo dañan propiedades adyacentes e interrumpen operaciones...
by Philip Wright | Aug 3, 2018 | General Litigation, Insurance Coverage Disputes
Given the aging infrastructure in Maryland, water pipe bursts like these are occurring more often. And they can cause major headaches. Besides disrupting traffic, they often damage nearby property and interrupt business operations. So who foots the bill when a burst...
by Gustavo Matheus | Jul 2, 2018 | Healthcare Appeals, Healthcare Reimbursement, Insurance Coverage Disputes
When Healthcare Services that are not Medically Necessary can be Reimbursed. Providers that know this one exception to the rule are less likely to leave money on the table. A mainstay of managed care is that coverage applies only to medically necessary services....
by Gustavo Matheus | May 24, 2018 | Healthcare Appeals, Insurance Coverage Disputes
How healthcare providers can avoid getting tripped up by the medical necessity requirement. The world of medical claims is littered with booby traps that can catch providers off guard. Our law practice has found that healthcare service providers often get tripped up...
