January 11, 2011

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Post-Payment Audits and ERISA:  Attorney encourages demanding ERISA rights when money is demanded

Post payment audit practices by commercial healthcare insurers are reaping millions of dollars for insurers.  However, the process used by many of the largest carriers to identify and collect overpayments is the subject of a number of current class action lawsuits.  If successful, these lawsuits may require insurers to provide more rigorous, claim-by-claim appeal review of the audit finding. . . .

Continue reading this article at AppealLettersOnline.com


AppealLettersOnline Featured Letters

We've added 35 new state-specific letters this month and 80 existing state-specific letter were updated to cite new information.  Click on the state name to see a list of affected letters for that state:

Arizona, California, Connecticut, Colorado, Delaware, Georgia, Hawaii, Idaho, Illinois, Indiana, Iowa, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Minnesota, Missouri, Mississippi, Nebraska, New Hampshire, New Jersey, New Mexico, New York, Nevada, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Dakota, Tennessee, Utah, Vermont, Virginia, Washington

Access these appeal letters at AppealLettersOnline.com

AppealLettersOnline.com Podcast

An Interview with D. Brian Hufford on Contesting Carrier Recoupment. 

Our interview with Mr. Hufford of Pomerantz, Haudek, Grossman & Gross law firm regarding post-payment audit litigation is available at http://www.appeallettersonline.com/downloads.php.  In the podcast, Mr. Hufford speaks about the recoupment litigation involving BCBSRI and also references related litigation involving Aetna and United Healthcare.  Listen to the podcast to hear his instructions on contesting recoupment efforts and also additional discussion regarding how class action litigation is being used to represent the large number of involved providers.  The actual court order regarding the case is at www.rid.uscourts.gov/menu/judges/opinions/recent/10272010_1-09CV0317L_BLUE_CROSS_V_KORSEN_P.pdf.  Complete information regarding Hufford’s firm is at www.pomerantzlaw.com or email him at dbhufford@pomlaw.com.

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