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California Healthcare Provider Reimbursement Attorney

As a healthcare practice, your business depends on getting paid. Unfortunately, compensation in the healthcare industry is far less straightforward than in other service industries. Healthcare providers are rarely paid directly by patients and instead provide services first, later to be reimbursed by insurance providers. The system inherently leads to disputes between providers and payers as to the actual or appropriate cost of services rendered.

A California healthcare provider reimbursement lawyer at the Law Offices of Art Kalantar can help you establish appropriate practices and procedures to ensure reimbursement runs smoothly and efficiently, and work with you to resolve any disputes over payments that may arise. We have experience advising hospitals, physicians, nursing homes, long-term care service providers, rehab centers, and any other type of healthcare practice regarding all aspects of healthcare reimbursement and coverage.

Medicare, Medicaid, Medi-Cal

Governmental healthcare programs make up the lion’s share of purchasers of healthcare services across the country and in California specifically. Healthcare providers must work within the regulatory frameworks governing these programs to ensure full and efficient reimbursement, and to avoid running afoul of any regulatory pitfalls. Medicare and Medicaid are complex regulatory schemes that require detailed understanding, and the services of a knowledgeable healthcare law attorney are vital to operating within them. Failing to abide by the myriad rules can lead to underpayment, costly penalties, or even revocation of enrollment in the programs and cessation of billing privileges.

The healthcare law team at the Law Offices of Art Kalantar has years of experience operating within these multifaceted and complex programs, developing creative solutions to individual problems as well as helping healthcare providers establish best practices to limit future problems and avoid legal troubles. We want to see you safely within all regulatory limits while still getting the coverage you are owed.

Resolving Disputes

At the Law Offices of Art Kalantar, we are prepared to represent your healthcare practice across a wide range of insurance payment and reimbursement issues, be they with private payers or insurers or with governmental healthcare payer programs. We represent clients in a wide range of matters, including the following:

  • Disputes regarding provider agreements or other service contracts
  • Enforcing commercial insurer compliance with preferred provider arrangements, treatment agreements, and third-party network contracts
  • Fielding COBRA disputes with employers over notice failures or failure to provide continuation coverage
  • Matters before the Provider Reimbursement Review Board
  • Challenging allegations regarding an overpayment, overbilling, duplicative billing, or audit penalties, as well as recoupment actions by the Centers for Medicare & Medicaid Services, third-party administrators, insurers, or health plans
  • Contesting denials of coverage, out-of-network designations, or out-of-network “usual, customary, and reasonable” litigation

Whatever your reimbursement-related issue, the Law Offices of Art Kalantar has the experience and the dedication to protect your healthcare practice and your bottom line.

Get Help With a California Healthcare Provider Reimbursement Matter

If you are facing a dispute over reimbursement for healthcare services you have provided or issues operating within the federal and state healthcare regulatory schemes, you need a zealous advocate in your corner who knows the laws, understands the finances, and will fight to ensure that your practice is protected and paid. Trust the Law Offices of Art Kalantar and our healthcare provider reimbursement lawyer for knowledgeable, talented, and effective legal assistance and representation with your healthcare law matters in Los Angeles and throughout Southern California. Call 310-773-0001 at any time to request a free case evaluation with the Law Offices of Art Kalantar in Beverly Hills.

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