Florida Healthcare Lawyer
Ferrer Law Group handles specific types of legal disputes that are interconnected with the firm’s consumer protection, commercial and insurance litigation practice areas. The types of cases are limited to legal disputes involving improper denial of benefits or coverage, and collection of improperly coded medical bills, frequently referred to as “upcoding,” “overbilling” and “balance billing.”
Medically Necessary
While the healthcare industry is heavily regulated, numerous issues affecting consumers directly go unnoticed. Oftentimes, heavy premiums are paid under a contractual insurance policy, only to later be denied an otherwise entitled benefit or coverage, under the guise that a medical treatment is “not medically necessary.” More disturbing is the numerous instances of individuals visiting an emergency room or other medical facility, for the same reason or cause for visit, only to leave with two differently coded invoices. (https://daveseminara.com/)
Ferrer Law Group vigorously handles consumers’ interests against improper and unorthodox claims denials, billing methods and unorthodox collection practices. The firm also protects client interests pertaining to patients’ rights. Contact us today!
Grievance Process
Under Florida Statute 627.6141, patients are entitled to participate in a grievance process that either the patient or a medical provider acting on your behalf, can appeal when a claim is denied as not medically necessary. Ferrer Law Group provides legal representation in all aspects of claim denials, up to and including the filing of a civil suit under various available remedies. This includes assisting with “expedited external reviews” for those with medical conditions that are of such urgency, that failure to provide timely authorized care can place a consumer’s health in serious jeopardy.
Overbilling, Upcoding, Balance Billing
Despite the health industry crisis, many consumers sacrifice a great deal to pay high premiums as consideration for medical coverage. Oftentimes, in addition to the exorbitant premiums and co-payments, a medical provider will improperly assign a code to it which determines the amount of monies a provider would otherwise get paid under the health insurance policy. When a pattern of erroneous coding is found, it may oftentimes be the result of medical upcoding fraud. The significance to the consumer when an improper code is assigned, however, can dramatically make a difference in the amount a patient would otherwise be responsible for under the particular insurance policy. Therefore, it is extremely important that the billing code matches the actual procedure or services performed.
Ferrer Law Group’s experienced Florida Healthcare Lawyers in this practice area can assist in identifying these types of issues and, where applicable, prove the upcoding is intentional and the balance billed is improper.
