Matters
- Represented hospital systems and physician groups in litigation against national insurers involving systematic underpayment and improper denial of out-of-network claims.
- Prosecuted claims under ERISA and state law to recover benefits owed for medically necessary services.
- Challenged payor downcoding, bundling practices, and reimbursement reductions inconsistent with plan terms and provider agreements.
- Represented providers in actions to recover payments under the MSP Act, including pursuing double damages claims against primary payors.
- Managed high-volume administrative appeals for denied and underpaid claims, including internal appeals and external review processes.
- Developed and coordinated appeals and litigation strategies to maximize reimbursement recovery across large claim inventories.
- Assisted in developing and litigating large-scale or aggregated reimbursement disputes involving systemic payor practices.
- Represented dialysis provider in high-dollar value network dispute in Hawaii State Court against national brands including MultiPlan, Inc.
