There are a lot of variables that come into play when you attempt to determine the potential reimbursement of any claim: the type of claim, what stage you are at in the process (submission or denial), your policy information (fully insured, self-funded, etc.), coverage information (deductibles, coinsurance, etc.), exclusions, whether it’s a state or federally governed plan, and who the players in the game are (UR Co, Ins Co.). Laypeople are generally less knowledgeable about the intricacies and the ins and outs of how to fight a claim denial. The initial consultation with our advocates is crucial in ferreting out the specific issues surrounding your claims and how to pursue them. The fight is never easy, but claims get overturned every day. Just last year we overturned over 40,000 days for our clients. Unfortunately, no one has a crystal ball and we know we cannot win every claim. Hence, our team helps you develop the best administrative record to pursue your post-appeal claims with legal counsel.
