In November 2021, Thompson Coburn’s health care litigators successfully resolved another set of payment disputes for a health care provider without the need to file litigation. In the most recent example of this highly effective payment strategy, Thompson Coburn secured significant insurer payments for client Vibra Healthcare for a set of claims related to Vibra’s care and treatment of patients at a rehabilitation hospital in El Paso, Texas.
The patients were all insured by the same Medicare Advantage Plan. Yet after the patients received care at Vibra’s rehab hospital, the insurer underpaid Vibra for its services and cited to improper technical bases for its failure to properly reimburse Vibra.
Faced with repeated refusals to compensate Vibra for services provided to covered patients, Thompson Coburn’s team notified the insurer of its violation of the parties’ agreement and improper underpayment and served the insurer with its draft demand for arbitration. The insurer subsequently agreed to pay the majority of claims.
This case is an example of a frequent problem for health care providers: Payers, including insurers and Medicare and Medicaid plans, that incorrectly deny or underpay claims. These denials and underpayments constantly threaten fluid revenue and operations of health systems.
Thompson Coburn’s national Health Care team has developed a highly effective — and highly cost-effective — approach to these types of payment disputes that empowers providers to recoup payments from payers. It’s a significant, value-added service that our attorneys have provided to health care providers across the country. For more information, please contact partners Mackenzie Wallace or Jenny Ecklund.