The Law Firm of Koth Gregory & Nieminski is uniquely situated to help hospitals, surgical centers, clinics, and medical groups increase revenue by obtaining the recovery they deserve on unpaid/underpaid accounts.
Koth Gregory & Nieminski (KGN) has provided legal services and process solutions for healthcare clients since 1990. KGN has obtained thousands of judgments, arbitration awards, and settlements resulting in more than 120 million dollars for their healthcare clients. KGN has obtained successful resolutions against all the major commercial insurers, including but not limited to Blue Cross, United Healthcare, Aetna, Cigna, and Health Alliance. KGN has also obtained successful resolutions against numerous large group health plans such as Nestle, Boyd Benefits, Contech Construction Products, and Shippers Rental to name a few. KGN’s process solutions have saved their healthcare clients billions of dollars and streamlined the dispute process so more dollars are recovered earlier in the process with training manuals that are easy for their clients’ employees to follow.
There are many issues facing healthcare providers and professionals, such as denial/underpayment of out-of-network claims associated with group health plans, medicare advantage plans, and individual insurance policies through the marketplace, issues with contract payers and preferred provider/managed care agreements, litigation under the Employee Retirement Income Security Act (ERISA) and Patient Protection Affordable Care Act (PPACA), obtaining judgments and collecting on patient responsibility accounts (uninsured patient accounts or balance billing accounts), pursuing healthcare liens, and navigating the issues specific to workers’ compensation accounts. The high volume of referenced based pricing denials, health sharing organizations, and the No Surprises Act can be difficult for healthcare organizations to navigate. If your facility has unpaid or underpaid accounts, KGN is the solution. Our recovery percentage is high and our cost-to-recovery ratio is low. Call (309)828-5090 or Click Here to take the first step towards obtaining the recovery your healthcare facility deserves.
KGN has a deep understanding of the needs of healthcare facilities due to our long-standing relationships with our healthcare clients. We provide a range of legal services, which includes but is not limited to litigating claims against non-contract payers under ERISA, PPACA, and Illinois state law, pursuing contract payers in court or via alternative dispute resolution (i.e. arbitration), and negotiating settlements on both non-contract payer and contract payer accounts. Our extensive experience reviewing the most intricate insurance policies, group health plans, and preferred provider contracts helps us resolve these accounts for our clients effectively and efficiently. Our reputation in the healthcare industry allows us to obtain recovery on many unpaid and underpaid accounts by simply sending appeal letters to payers because they know if the account has been referred to our office, we will hold them accountable through litigation or arbitration if they do not make appropriate payment.
When patients have an injury claim, we submit lien notices and file petitions to adjudicate our clients’ healthcare services liens. We have seen several healthcare clients be dissatisfied with the services offered by vendors that claim to be experts on healthcare lien law. The problem with these vendors is that they often do not understand the law, are unable or unwilling to go to court, or lack the meticulous follow-up necessary to ensure the healthcare client receives the best outcome. These vendors consistently fail to send proper lien notices to all entities involved in the case which often results in no recovery. These vendors also fail to understand the healthcare client’s contracts with commercial health insurers which often results in underpayments or no recovery at all. A significant portion of the healthcare lien business KGN receives from clients has come from hospitals after they used a healthcare lien vendor that made mistakes. The healthcare attorneys at KGN have superior knowledge and experience with healthcare liens and are the best option for any healthcare entity.