The attorneys, paralegals and professionals in Miller Johnson’s Med Recovery Group provide litigation and counseling to medical providers seeking insurance reimbursement on patient accounts. Our group pursues wrongful denials of hospital and provider claims by third-party payers, including no-fault carriers, workers’ compensation carriers, commercial and health insurance plans and government plans.
We generate revenue for medical providers through litigation and training in:
- No Fault eligibility, coverage, causation and priority disputes under Michigan’s No Fault Insurance Act;
- Health Plan eligibility, coverage, causation and priority issues including pre-authorization disputes, priority disputes, denials for pre-existing conditions, COBRA eligibility, and ERISA preemption;
- Insurance payment issues arising under the No Fault Fee Schedule, the Worker Compensation Fee Schedule, ERISA health plans, HMOs and Government plans including partial payments, mistaken payments, fee schedule errors, “customary and reasonable” underpayments, third party audits and balance billing issues;
- Contractual issues and audits with Medicare, Medicaid, Tricare, group health plans, managed care entities and No Fault Networks.
- Charging lien or fee claims against hospitals and medical providers from attorneys representing patients in liability claims.
Miller Johnson’s Med Recovery Group assists medical providers by
- Decreasing accounts receivables days
- Decreasing self-pay accounts and uncollectible write-offs by obtaining payment from insurance
- Increasing collections and the bottom line by challenging improperly denied claims.
Miller Johnson’s Med Recovery Group routinely recovers interest and attorney fees from insurers for wrongful denials by enforcing state and federal laws requiring prompt payment of claims. We provide 24/7 live access to all referred account through a secure SharePoint portal. We also provide training and legal updates to medical providers through Client Alerts, electronic bulletins and training videos.
Our group’s litigation and counseling have provided our hospital, health system and medical provider clients with a much-decreased timeframe in accounts receivable and significant decreases in self-pay accounts and uncollectible write-offs.
Miller Johnson’s Med Recovery Group provides Revenue Cycle counseling and litigation to health systems and providers throughout Michigan. Some representative clients include:
- Spectrum Health System (Grand Rapids, MI)
- Spectrum Continuing Care, Spectrum Health Big Rapids, Spectrum Health Gerber, Spectrum Health Ludington, Spectrum Health Pennock, Spectrum Health Reed City, Spectrum Health United/Kelsey, Spectrum Health Zeeland and Spectrum Health Lakeland
- Mary Free Bed Rehabilitation Hospital (Grand Rapids MI)
- Bronson Methodist Hospital (Kalamazoo, MI)
- Covenant Healthcare (Saginaw, MI),
- Henry Ford Health System (Detroit, MI)
- Holland Hospital (Holland, MI),
- Oaklawn Hospital (Marshall, MI)
- University of Michigan-West (Grand Rapids, MI)
In the past 3 years, our group has recovered more than $100 million in denied charges and over $3.0 million in interest and attorney fees from insurers for wrongful denials.
In addition to our counseling and litigation services, our group provides training to Patient Financial Services representatives on billing and coding issues, no-fault eligibility and coverage issues, appeals to government payers, HMOs and ERISA plans on denied claims and compliance under the Fair Debt Collection Practices Act. We have also designed and implemented Denial Management Protocols for our hospital clients. We provide both in-house training seminars and electronic notifications regarding legal issues affecting reimbursement.