Overpayment Reduced by Two-Thirds

Posted on Firm News by author

Through an aggressive appeal effort, attorney Erin Bengele secured a substantial reduction in a private insurance overpayment demand for a pharmacy client of the Firm. Ms. Bengele prepared a detailed claim-by-claim rebuttal of the purported basis for denial, ultimately reducing the overpayment by two-thirds.

Among other things, Ms. Bengele pointed out factual errors by the insurance carrier, highlighted the pre-approvals by the carrier, and highlighted that some of the bases for denial were not permitted by the provider agreement.

The attorneys at Nicholson & Eastin, LLP regularly represent providers in payment disputes, and are often able to identify bases for reversal of the overpayment demands. If you are the subject of an audit or overpayment, please contact the firm for a consultation.