Payer Disputes

The rising occurrence of underpayments


It is becoming more and more common that payers are violating physician and hospital payer contracts and under paying their network of providers


I think we are being underpaid, what can we do?

Our firm has helped numerous providers – both large and small seek repayments from payers on underpaid or non-paid claims.  We help you evaluate the rights and legal protections guaranteed to you in your managed care agreements.  Payer contracts are valid and enforceable but many payers count on providers doing nothing about it.

  • Our team will review your claims and contracts to determine eligibility
  • We work on a commission basis only for this service, we collect a percentage of the net collection recouped from the payer
  • Our firm has the relationships, connections and legal power to support and defend our clients against even the biggest payers

Out-of-Network Arbitration


Our firm has national influence and expertise in out-of-network, managed care arbitration


Payers have unliterally down coded and squeezed out-of-network providers following the implementation of the No Surprises Act


We help hospitals and hospital based physician groups who see and treat some of our most vulnerable members of society stop payers from paying providers below market rates.  Our firm has extensive experience in the following areas:


  • Comprehensive reporting and analytics around “Qualified Payment Amounts” and helping providers in court establish reasonable charges and fees that equal or exceed the QPA
  • Litigate commercial and managed Medicare / Medicaid payers to establish appropriate payment rates for services provided out-of-network
  • Leverage success of arbitration and litigation to a negotiation strategy that yields a payer contract that is at or above market rates for services provided
  • Successfully navigate and advise clients the requirements to arbitrate claims