Non-contracted Reimbursement

Obtaining fair reimbursement is one of the biggest challenges for out-of-network healthcare providers – especially for hospitals, professionals, ambulance services, and others who render emergency services.  Athene Law can help.  Its experienced attorneys are not only adept at pursuing such reimbursement through pre-litigation appeals, legal demands and, where necessary, through litigation.  Athene Law understands the importance of obtaining the appropriate rights from the patient.  Athene also advises clients on how to best leverage the Independent Dispute Resolution (IDR) procedure under the No Surprises Act and pursuant to procedures established under state surprise billing laws.

Capabilities

Athene Law helps its provider clients pursue non-contracted reimbursement in a variety of ways and advises on the following issues and more:

• Letters of agreement
• Direct contracts with employer-sponsored self-funded health plans
• Appeals to commercial and government payors and health plans
• Disputes with independent physician associations (IPAs), medical groups, and other delegated entities for which there are no reciprocal rates
• Notice & Consent to be balance billed under the No Surprises Act
• Perfection and enforcement of liens under the California Hospital Lien Act
• Coordination of benefits issues
• Model patient assignments of benefits / conditions of admission forms
• Good Faith Estimates for self-pay patients