Texas Prompt Pay Litigation

Texas Prompt Pay Litigation

Helping Texas Medical Providers

Are you fighting to collect insurance reimbursements that are properly owed to your practice? As the spouse of a family practice physician, I understand all too well the frustrations associated with insurance companies that underpay, slow pay or simply “no pay” a medical provider’s legitimate claims for reimbursement.

While all practices vary, my wife has found after thorough review of her practice’s financials that, despite the use of experienced, well-respected and expensive third-party billing companies, the amount of unpaid reimbursements is not measured in the thousands, but hundreds of thousands of dollars per provider over the last few short years. These losses are directly attributable to assorted carriers failing to honor their reimbursement contracts. Meanwhile, insurance carriers continue to enjoy huge profits. According to the American Medical News, many major carriers have expressed their current intent to continue to maximize their profits by increasing premiums while continuing to slash provider reimbursements.  See American Med. News, Aug. 23, 2010 at 33.

Did you know that your practice has the right to recover fees owed to it without the fear of retaliation from insurance carriers? By employing counsel you can avail yourself of your rights under Texas’ prompt pay laws – laws created by the Texas Legislature for you, the medical provider – when insurance companies fail to live up to their written agreements. Recovery is relatively fast in comparison to other legal proceedings because many provider contracts require binding arbitration. Additionally, because the arbitration is binding, any award entered in your favor cannot be appealed except in very limited circumstances, which helps insure that you enjoy the benefits of any award sooner than later.

Successfully recovering fees that are owed to medical providers takes the experience of a team of professionals. We couple our knowledge of the law with the experience of health care and information technology professionals to accurately analyze reimbursements and compare them to your practice’s reimbursement contracts to help your practice receive all that it is owed. We can do this by employing computer analysts that create specific software to interface with your billing records, which enables us to efficiently analyze up to millions of claims. Because of the costs involved in prosecuting cases like this, this firm will likely refer the case to additional counsel to assist in the matter.

Pursuing reimbursements owed to you under your contracts also doesn’t need to distract you from your practice. We understand that your schedules are demanding and that the success of your business depends on attending to your patients’ current needs. To prevent interruption of your practice, we can meet your IT professionals directly to formulate and enact a plan to secure and analyze your practice’s billing records. Of course, our analysis of such records is done to protect the attorney-client privilege and comply with all HIPAA requirements.

We also understand that your decision to enforce your rights is a business decision and that the dollars and cents must make sense. Ordinarily, employing attorneys, information technology professionals and other experts to battle wealthy insurance companies would be an expensive endeavor and usually cost prohibitive. However, if your practice wants to recover what the insurance carriers promised to pay you in exchange for your hard work, we can assist you without exposing your practice to the risk of additional loss. We advance all costs of prosecuting your case, including all expert fees. And, if for any reason, we do not recover an award in your favor, you owe us nothing.

If you would like more information about how we can help you collect what you have already earned, please contact The Law Office of Daniel O’Brien, P.C. at 512-615-3580. We are happy to set-up a presentation at your office and discuss your potential claims at time convenient to you.

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