Is your treatment center losing money due to extremely low reimbursements and unfair or excessive denials from commercial insurers?  Do third-party pricers attempt to negotiate your rates below what it actually costs for you to provide services?  Do you think these practices are in violation of the federal Parity Act?  They are.  Things will not change, however, unless the treatment industry takes a stand.  It starts with providers like you.  Let the highly experienced attorneys at Napoli Shkolnik PLLC review your claims for Parity violations and help you fight back against the insurance companies.  There is no fee for our services unless we successfully recover money for your facility.  Let us help you win back millions in lost and written-off revenue and force the insurers to comply with the law.

Impact:

  • Recoup hundreds of millions of dollars, possibly billions of dollars, in unpaid or partially denied claims

  • Reset the playing field to make sure all providers get paid what they are owed in the future

  • Increase access to treatment for millions of commercially insured plan holders and their dependents

Let’s Talk

Low Usual and Customary Rates

Insurers routinely set their usual and customary rates using illegal methodologies based on invalid and incomplete information. Federal law prohibits this practice and provides a monetary remedy for providers who have suffered from systematic low reimbursements.

Treatment Limitations

As your Utilization Review (UR) Department can testify, it is a constant battle to get patients the care they deserve. Providers must often scholarship, discharge, or lower patients’ levels of care prematurely.

We will recover lost revenue from scholarships and premature step-downs in level of care.

Illegal Audits/Pre-payment Review

Insurers have a long history of placing providers in “pre-payment review” or other audits. Many of the claims subject to review under those policies are never paid or are denied on illegal grounds.

We will analyze and recover revenue lost from illegal pre-payment review and audit practices, as well as get you compensated for the time spent compiling and submitting medical records during such audits.

Abusive 3d Party Cost Containment

Insurers regularly contract with third party Cost Containment Companies or Pricers to strategically minimize reimbursements.

We will review negotiated rates and seek to enforce Parity and other applicable laws against cost containment companies who engage in abusive pricing and negotiation practices.

We will aggregate claims data from all participating providers to establish the largest claims and reimbursement pools possible against each defendant insurer.

$0
Million

Estimated average annual write off for a typical 40 bed residential treatment facility due underpayments and other Parity violations by insurers.

$0
Billion

Total estimated annual unpaid insurance claims due to Parity violations across the industry, which includes over 7,000 residential treatment centers and 8,000 partial hospitalization or outpatient centers.

EXPERIENCED LAWYERS

Have recovered $4 Billion+ from insurers and others

FREE ANALYSIS OF CLAIMS

There is no cost to have your claims data analyzed for Parity violations

$50M – $2B recovery

Projected value of cases. The more providers who participate, the more we will recover