Callender Bowlin currently represents numerous Free Standing Emergency Rooms (FSERs) across the State of Texas, and these facilities and physician groups provide an invaluable service to their customers, often providing medical care in life-or-death situations. These facilities provide unparalleled convenience for timely and efficient emergency care to patients. However, insurance companies are jeopardizing this relationship by arbitrarily refusing to pay valid claims or by refusing to pay the full amount of the claim as required by the law.
FSERs are under attack. Insurance companies are refusing to follow the law and reimburse clean claims as required. As a result, patients who visit emergency care centers are often surprised with hefty medical bills. This dilemma is created by the health insurance companies’ refusal to cover and reimburse appropriate expenses related to the visit. Patients are understandably outraged at the unexpected bills but wrongfully believe the emergent care center is to blame.
FECs are being put in a precarious situation. When patients inquire about the cost of medical treatment, FECs often cannot reasonably provide an accurate answer because they cannot predict what a health insurance company will reimburse. FECs are required to be reimbursed in accordance with the law, and the law is specific about what reimbursement must be made. Despite what the law requires, the health insurance companies are simply ignore it. Unfortunately, the health insurance companies’ behavior can create the perception that emergency care facilities are not being transparent and honest in their billing practices, which can hurt the facility’s reputation and overall business.
CB Trial is currently representing these physician groups and facilities against some of the largest insurance companies in the world. If you are involved in a physician group, hospital or treating facility and are experiencing slow pay, underpayment, and denial of claims, call our firm today.
