Samantha Flener is an associate in the Health Care Litigation and Disputes practice in Nashville. She works with a wide range of health care entities, including profit and not-for-profit hospital systems, ambulatory surgery centers, air ambulance services, specialty providers, physician groups and ancillary service providers, and medical device companies to develop smart and efficient solutions tailored specifically to client needs.
Samantha’s representative work includes:
Managed Care Disputes
Samantha serves clients on a variety of managed care matters including disputes related to underpayments, medical necessity denials, attempted recoupments and offsets, contract interpretation, refusal to contract, discrimination and retaliation against out-of-network providers and related reimbursement disputes, and related legal issues involving the Affordable Care Act, ERISA preemption, UCR laws, EMTALA, HIPAA, prompt pay laws, and laws regarding payor audits, recoupments and offsets.
Managed Care Strategy
Samantha consults with healthcare providers on in-network and out-of-network strategies and other issues involving the relationships among providers, insurers, self-funded plans, benefit administrators and vendors. She counsels providers on challenges such as payor coverage and reimbursement policies, reference-based pricing initiatives, surprise medical billing, ERISA and ACA laws, hospital lien laws and persuading payors to cover medical devices and procedures.
Samantha’s previous experience as a Hatch-Waxman litigation associate at a top national law firm enables her to develop intelligent solutions to complex problems while maintaining cost-consciousness, and her STEM background enables her to substantively engage with the science attendant to certain types of health care work, such as medical necessity denials.