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Insurance Claims Health Care Providers Billing

Marshall Dennehey

Commonwealth Court Rejects Insurer’s Reimbursement Claim Against Pharmacy in Billing Dispute

Marshall Dennehey on

Pioneer Construction Company, Inc., Eastern Alliance Insurance Company, and employers Alliance, Inc. v. Insight Pharmaceuticals, LLC d/b/a Insight Pharmacy; No. 867 C.D. 2022; filed May 12, 2025; Judge Covey - A workers’...more

ArentFox Schiff

Dispute Not Resolved: BCBSGA Sues Providers for Alleged Misuse of NSA Arbitration Process

ArentFox Schiff on

On May 27, Blue Cross Blue Shield Healthcare Plan of Georgia, Inc. (BCBSGA) filed a lawsuit in the Northern District of Georgia US District Court, alleging that a group of health care providers, along with their third-party...more

J.S. Held

Inside the Healthcare Industry: The Critical Role of Medical Coding, Billing & Nurse Review

J.S. Held on

In what is already a highly regulated industry, it is becoming increasingly difficult for healthcare organizations to navigate the growing volume, complexity and enforcement of laws, regulations and guidance that surround...more

Kerr Russell

Did I Commit Fraud?

Kerr Russell on

Question: I am under audit by a dental plan I participate with. The audit has identified a few issues in connection with how my billing employees have been submitting claims for payment. For example, the name of the treating...more

Foley Hoag LLP

New Massachusetts Bulletin Makes COVID Testing Reimbursement Easier

Foley Hoag LLP on

In an effort to make it easier for laboratories to be reimbursed by insurers for COVID-19 testing, the Massachusetts Division of Insurance has issued a bulletin stating that it expects “carriers to relax” restrictions on...more

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