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Who's Paying the Bill

Healthcare providers occasionally run into situations where a patient will have coverage under two health plans. Ironically, because of misunderstandings between the two plans, neither plan will ultimately pay the … See more

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URL: https://www.andersonquinn.com/who-pays-medical-bill/

Untimely Billing and Coordination of Benefits Anderson & Quinn

WEBAnderson & Quinn, LLC is a renowned law firm based in Rockville, Maryland, providing individuals, businesses, corporations, and healthcare institutions with the legal …

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Medical Care Guidelines are Not Medically Necessary

WEBThe health plan asserts that the last two days of inpatient care were not medically necessary, and therefore will not be reimbursed. The Problem. However, the …

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HIPAA Privacy Rules Attorney Requests for Records Anderson …

WEBAnderson & Quinn, LLC is a renowned law firm based in Rockville, Maryland, providing individuals, businesses, corporations, and healthcare institutions …

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Joint Operating Committee Health Care Anderson Quinn Blog

WEBGustavo Matheus is a member of Anderson & Quinn, LLC, in Rockville, Maryland, representing hospitals, medical practices, nursing homes, and outpatient …

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Hospital Reimbursement Timely Billing Avoids Lost Payment AQ …

WEBMost health plans have contracts with hospitals that require billing within 180 days of the date of service. Some self-insured plans allow hospitals to submit their bills …

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Healthcare Reimbursement Legal Practice Anderson Quinn

WEBAnderson & Quinn has established a solid reputation for representing healthcare entities in the recovery of denied, unpaid and underpaid claims from third-party payers. We …

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Medicaid Admin Fair Hearings Healthcare Law Anderson Quinn

WEBMedical Assistance is a federal program administered at the state level. The federal laws that regulate Medicaid (as it is more commonly known) in most cases require that …

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Revamping Prior Authorization Laws in Managed Care

WEBTwo of Maryland’s managed care laws need to be changed or at least clarified. These modifications are necessary to preserve the Medicaid system’s integrity …

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Denied Claim Litigation Healthcare Reimbursement Anderson …

WEBAnderson & Quinn evaluates denied claims against the terms of the provider contract and helps our clients determine the next steps in proceeding against a payer’s improper …

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Benefits of Exhausting Denied Claim Appeals Anderson Quinn

WEBThis prospect highlights one important point of awareness: Providers must file timely denied claim appeals through completion of the appeals process. Indeed, …

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Milliman Poor Substitute for Medical Judgement in Claim Denials

WEBIn reality, Milliman criteria act as a poor substitute for medical judgment in payers’ evaluation of provider claims. Despite employing their own in-house medical …

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Five Reasons to Update Managed Care Contracts Anderson Quinn

WEBSpecifically, here are five key reasons to consider updating open managed care contracts: If the parties have not evaluated the contract in more than three years. …

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Working Capital Allowance Loophole Hurts Hospitals Anderson …

WEBA legal loophole found in the Maryland Health Services Cost Review Commission (HSCRC) regulation (COMAR 10.37.10.26B), titled Working Capital …

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Prior Authorization Not Guaranteed Payment Anderson Quinn

WEBNormally, this provision applies to claims for a service that was not preauthorized or else deemed by the plan as being not medically necessary. In other …

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Maryland Prompt-Pay Statute Impacts Claims Payment

WEBUnder the statute, payers still must pay the undisputed portion of the claim within 30 days. And the law stipulates that health plans subject to the statute allow …

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Resolving Managed Care Denied Claims with Litigation Anderson …

WEBAnderson & Quinn, LLC is a law firm based in Rockville, Maryland, providing individuals, businesses, corporations, and healthcare institutions with the legal and …

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Treating Medicare Home Health Beneficiaries LegalHealth

WEBThe Balanced Budget Act of 1997 established Medicare’s Prospective Payment System (PPS) for Home Health beneficiaries who receive covered services, …

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