Health Management Organizations (HMOs) and Health
Insurance
For most people, health insurance is a necessity.
With the sky rocketing costs of medical care, even the simplest
procedures can cause a great financial burden. You bought health
insurance so that it would cover you and your family when you have a
claim. You paid the premium assuming that if you or a family member
becomes ill or injured, your costs will be covered. When your insurance
company denies or delays a claim, this can cause significant financial
hardship.
Health insurance policies are complex and
confusing documents with varying amounts of coverage, deductibles and
networks. Most people never actually see a complete copy of their
policies and the extensive terms and conditions that can affect their
benefits. Nierman Law, P.L.C. can assist you if your claim for benefits
is being denied or delayed. We can review your policy, help you
understand your options for pursuing benefits, and deal directly with
the insurance company on your behalf. In some cases, your insurance
company may be forced to pay you punitive damages because of bad
faith claim handling.
Our services include resolving all types of
insurance denials and delays, including but not limited to:
- Delays and Underpayments
- Usual, Customary and Reasonable (UCR)
- Medical Necessity
- Pre-Existing Condition
- Contractual Disputes
- Silent PPOs
- Precertification
- Coordination of Benefit issues (COB)
- Personal
Injury (liens)
- Workers Compensation
- COBRA
- Refund Requests
We have experience obtaining coverage for clients
who required complex and expensive medical procedures. Read more about
some of these client successes. Disputes
over coverage most often occur when you require major surgery or
long-term care. However, denial of the medical care you need,
regardless of severity, can create a stressful financial and medical
situation.
What can I do if my insurance company
wrongfully denies my claim?
Contact us today for your free initial telephone
consultation.
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