Physicians and Physician Groups

Parrish Law Offices helps physicians and physician groups across the country. We are experienced in working with physicians and physician groups practicing in the following areas: cardiology, orthopedics, neurology, nephrology, pain management, anesthesiology, oncology, and family medicine.

Addressing Claims Denials

According to government reports, only 2.5% of denied Medicare Part B claims are appealed, even though more than 50% of appeals are successful. Similarly, only approximately 10% of commercial payer denials are appealed.

We are one of the top filers of appeals before the Office of Medicare Hearings and Appeals (“OMHA”); we have participated in more than 1,000 cases. Through these appeals, we have succeeded in (1) recovering reimbursement on previously-denied claims, and (2) establishing favorable claims treatment going forward, thus ending the need for further appeals. Similarly, we have appealed numerous denials by private insurers and state Medicaid agencies.

Resolving Audit Matters

Physicians are increasingly subject to both pre-payment and post-payment audits conducted by both public and private payers. These audits may relate to matters on which physicians have relied on coding consultants and/or suppliers and other health care partners.

We have expertise in handling public and private payers audits, including RAC, ZPIC, CERT, QIO, MIC, and additional audits. We use our extensive experience handling OMHA and additional administrative/agency appeals and, where it makes sense, we also use negotiations to – again – both successfully resolve current audits and minimize audit issues going forward.

 Additional Matters

We have drafted and negotiated contracts for large practice groups with hospital systems. We also have developed leased employee agreements, and we have provided training on HIPAA and on various billing and coding matters.