Phone: 302.658.4265
Health Law

Health Care Reimbursement Advice

The success or failure of a health care venture is largely dependent on the ability of the venture to obtain payment in a timely manner. Balick & Balick assists health care providers in maximizing reimbursement from Medicare, Medicaid, and other government and private payors.

Balick & Balick counsels clients on regulatory and contractual requirements for obtaining reimbursement from government and private insurers. We also provide competent representation to these clients when a dispute arises with such insurers. Notably, our attorneys provided input to the Delaware Department of Insurance when it promulgated regulations aimed at enhancing providers’ ability to challenge claims denials by private health insurers.

Our attorneys advise health care providers regarding legal responsibilities in redressing overpayments and billing errors and assist them with voluntary disclosures and repayments to private and federal insurers. Balick & Balick also represents providers in connection with government administrative contractor audits.

Representative Matters:

Represented a pain management medical practice in connection with an investigation brought by the Department of Insurance Fraud Prevention Bureau and negotiated a reimbursement arrangement without an acknowledgment of wrongdoing by the medical practice.

Represented a physician in connection with an action by a Medicare Program Safeguard Contractor seeking reimbursement of claimed overpayments of approximately $250,000.

Advised a medical practice on the process for challenging a health insurance carrier’s denial of payment on the basis that the treatment was experimental.

Counseled a health care provider in connection with voluntary repayment of Medicare overpayments.

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