Health Insurance Litigation
Where Healthcare, Commerce & the Law Meet.
D.S. Erickson & Associates, PLLC, represents numerous healthcare systems and providers with myriad issues involving third-parties in the area of Health Insurance Litigation, involving health insurance companies, third-party administrators, repricing concerns and related parties.
This practice area is utilized by providers seeking payment for services that insurers have either underpaid, delayed, or wrongfully denied. Disputes of this kind often arise from disagreements over coverage interpretation, contractual reimbursement rates, or improper claims processing.
Health insurance litigation typically begins with an internal appeal or negotiation process directly with the insurer or third-party administrator since many disputes can be resolved without resorting to formal legal proceedings. Insurance coverage and denial disputes are handled from negotiation through Federal Court litigation by firm lawyers, giving clients a single point of contact whether a matter resolves informally or requires a full court proceeding.
This continuity allows our firm to build a strong factual and legal record from the outset, which proves valuable if the dispute later proceeds to litigation.
Repricing disputes, a common issue in this particular area, often occur when a third-party administrator reduces a provider’s billed charges based on a network agreement (or other repricing methodology) that the provider believes was improperly applied.
These disputes require a very detailed understanding of provider contracts, claims data, and applicable insurance regulations in order to challenge improper reductions. D.S. Erickson & Associates brings combination of deep healthcare industry knowledge and litigation experience to each engagement.
Disputes between firm clientele and opposing parties will always receive careful attention and handling, with our firm recognizing that not every matter needs to proceed to a courtroom.
D.S. Erickson & Associates firmly believes that litigation is not always required to resolve every dispute, and our firm regularly works to reach favorable resolutions through negotiation before pursuing more costly and time-consuming health insurance litigation.
D.S. Erickson & Associates, PLLC is proud to represent businesses and individuals in a range of matters. Our other areas of practice include:
Consumer Debt Collection
Collecting unpaid debts in a highly-compliant, professional and effective manner.
Business Law
Handling legal transactions, business formation, succession planning, dissolution, contract drafting, review, negotiation and general business representation.