More Case Victories
We’re not ones to brag. We’d prefer to think of ourselves as the “strong but silent type”. But make no mistake. As the results we’ve achieved suggest, we’re ready to do everything in our power to realize the desired results for our clients. Whether it’s shortening revenue cycles or maximizing reimbursements, our focus is on financial recovery and attaining the most favorable results that are in our clients’ best interests.
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$162.62
Proposed ACDF @ C4-5 awarded
5/5/2020
FR# 1876759 -
$120.35
Office visit awarded in OTP case, patient still symptomatic
4/20/2020
FR# 1866947 -
$1,593.50
Cervical facet injections awarded as diagnostic to guide further treatment
4/18/2020
FR# 1859865 -
$240.70
Proposed C5/6 C6/7 awarded, IME that patient plateaued from injections supported surgery
4/4/2020
FR# 1853725 -
$1,385.63
Cervical MBB, PT and office visits all awarded
3/29/2020
FR# 1870209 -
$178.90
ASC overturns improper healthcare primary payment
3/26/20
FR# 1867175 -
$203.66
Office visits and proposed 3 level fusion from C4-C7 awarded following failed pain management
3/22/2020
FR# 1860767 -
$808.12
3rd lumbar facet awarded when IME was less than 1 month after 2nd facet
3/13/2020
FR# 1852450 -
$85.31
Proposed reconstruction of pre=accident lumbar fusion at adjacent L3-4 level related to accident and awarded
3/12/2020
FR# 1850461 -
$462.26
Topical Flector patch necessary when OTC meds, PT, injections and brace failed to relieve knee pain
3/11/2020
FR# 1859045 -
$
Proposed interbody fusion and posterior decompression at L5-S1 approved
3/11/2020
FR# 1863403 -
$1,990.65
MMRF, anesthesia billed properly for cervical facets, 100% demand awarded
2/18/2020
FR# 1859794 -
$
Proposed left ankle reconstruction awarded after failed PT
2/13/20
FR# 1865271 -
$2,109.73
Topical analgesic/anti inflammatory medications awarded as alternative to opioid medications
1/21/2020
FR# 1855495 -
$
Proposed lumbar laminotomy/discectomy at L5-S1 awarded for 25 year old
1/21/2020
FR# 1847526 -
$1,887.30
Testing localized pain generators and guided further tx, awarded in full
1/2/2020
FR# 1860173 -
$1,100.44
Office visits and CESI awarded, & pre-cert penalty overturned
1/1/2020
FR# 1822297 -
$1,327.33
EMG/NCV awarded after failed chiro treatment and unexplained radiculopathy
12/31/2019
FR# 1858092 -
$1,332.97
NY insured injured in NJ accident, deemer statute applied and NJ PIP awarded
12/30/2019
FR# 1848193 -
$86,991.54
Limited $15k policy expanded for severe ankle fracture requiring ORIF & 5 day admission
12/11/2019
FR# 1850293 -
$29,621.83
Pt. admitted to ICU for tx of rib fractures sufficient to expand policy past $15k limit
12/2/2019
FR# 1837994 -
$240.70
2 Office Visits awarded in OTP, despite 9 moth gap in treatment
12/2/2019
FR# 1843737 -
$4,130.18
2 LESI, CESI awarded for aggravation of pre-existing condition over causation defense
12/2/2019
FR# 1836840 -
$13,245.82
CESI, LESI, EMG, discography and biacuplasty all awarded
12/2/2019
FR# 1841514 -
$210,731.54
LESI, 3 level lumbar fusion, follow care awarded over IME denying further treatment
11/19/2019
FR# 1818506 -
$23,121.09
Hospital awarded full PPO amount owed
11/17/2019
FR# 1854418 -
$2,109.73
Medications prescribed as opioid alternative deemed medically necessary & awarded in full
11/15/2019
FR# 1851436 -
$10,308.94
Shoulder surgery & PM injections awarded in full
10/27/2019
FR# 1829751 -
$2,736.11
Shoulder MUA awarded, IME from 1st failed defense of arb rejected in 2nd arb as well
10/27/2019
FR# 1812913 -
Proposed MUA of wrist/hand awarded after post-fracture wrist brace denied
10/17/2019
FR# 1843357 -
$1,592.47
EMG/NCV awarded where MRI positive, and later PM injections performed and paid
10/15/2019
FR# 1846299 -
$3,324.19
Bilateral Upper & Lower EMG awarded based on documented neurological deficits
10/12/2019
FR# 1845064 -
$8,824.86
Hospital has standing because carrier never served DPRP, recovers UCR for ER services
10/4/2019
FR# 1845064 -
$345.24
Proposed 3 Level cervical fusion awarded, stale IME before numerous pain mgmt. procedures
10/4/2019
FR# 1831908 -
$13,114.33
Hospital recovers UCR after being grossly underpaid for ER services
10/3/2019
FR# 1842599 -
$23,175.21
Limited $15k policy expanded for hospital treatment of multiple lacerations, fractured jaw
10/2/2019
FR# 1842802 -
$3,848.98
100% awarded to hospital for radiology performed in ER, UCR proofs overcome defense
9/27/2019
FR# 1836560 -
$4,637.31
Proposed left shoulder rotator cuff repair authorized, and all treatment awarded
9/27/2019
FR# 1838178 -
$3,430.41
3 CESI awarded, despite no EMG, as radiculopathy documented on exam and 1 level on MRI
8/21/2019
FR# 1830294 -
$2,097.72
Topical analgesic/anti inflammatory medications awarded as alternative to opioid medications
8/14/2019
FR# 1833105 -
$2,463.83
100% of PT awarded for 15 y/o treating for AMPS
8/5/2019
FR# 1830392 -
$910.13
100% of radiology services awarded in OTP claim
8/5/2019
FR# 1828303 -
$1,995.39
EMG, & subsequent epidural, necessary to treat radiculopathy
8/2/2019
FR# 1832337 -
$2,655.05
Discography and proposed 3 level cervical fusion awarded
8/2/2019
FR# 1833367 -
$3,740.87
Trigger point injection and lumbar discography granted over IME
7/8/2019
FR# 1826290 -
$7,378.00
Aggravation of pre-ax cervical injury awarded at 100%
7/8/19
FR# 1812698 -
$33,738.30
Additional $33k UCR award for thoracic decomp/fusion
7/7/19
FR# 1825864 -
$2,896.20
lumbar discogram awarded in full!
7/6/19
FR# 1819898 -
$19,687.61
Endo lumbar discectomy, cerv. decompression and future lumbar fusion all awarded
7/3/19
FR# 1805433 -
$20,485.85
$15k policy expanded for patient who suffered multiple significant injuries
7/1/19
FR# 1814978 -
$2,791.21
Thoracic RFA resulting in 95% improvement awarded.
6/28/19
FR# 1821330 -
$2,126.14
ACDF @ C4/5, C5/6 awarded as medically necessary & related to ax
6/23/19
FR# 1816522 -
$9,307.66
small finger trigger release surgery and post-sx PT awarded
6/21/19
FR# 1816498 -
$12,065.42
Detailed records support medical necessity of lumbar/cervical injections
6/21/19
FR# 1809621 -
$5,112.88
Proposed C3/4, C4/5 Fusion with PEEK cage awarded
6/20/19
FR# 1831917 -
$3,141.80
Bilateral Upper & Lower EMG awarded plus follow up visits
6/20/19
FR# 1815511 -
$157,033.40
Microdiscectomy, open fusion at L2-3 and PT all awarded in full!
6/8/19
FR# 1755630 -
$176,187.73
3 Level cervical fusion awarded despite pre-ax MRI showing herniation – aggravation under Bowe
6/4/19
FR# 1818505 -
$13,203.06
Hospital awarded UCR, carrier’s “audit” by CPC rejected
5/30/19
FR# 1808766 -
$630.00
Post-PRP physical therapy awarded in full
5/30/19
FR# 1822298 -
$1,389.17
Bilateral upper EMG/NCV awarded against insurer “obvious diagnosis” defense
5/14/19
FR# 1825908 -
$131.87
Proposed 3 Level cervical fusion awarded 5 years after accident date
5/13/19
FR# 1818503 -
$525.00
Full amount of PT awarded after MDR termination
5/6/19
FR# 1812876 -
$
Prospective left knee arthroscopy awarded
5/3/19
FR# 1807011 -
$928.81
RF Ablation awarded after premature IME denial
5/1/19
FR# 1805180 -
$22,700.00
$22k+ awarded for UCR reduction of spine surgery
4/19/19
FR# 1810491 -
$32,800.00
Nasal, rib and multiple cervical fx deemed “significant” and $15k policy expanded to cover hospital tx
4/14/19
FR# 1815525 -
$566.86
Proposed 2 Level lumbar fusion awarded after extensive PM
4/13/19
FR# 1778184 -
$3,065.08
100% of anesthesia awarded for various PM procedures
4/13/19
FR# 1790821 -
$7,058.15
SI injection, MBB & RF ablation necessary to treat multiple lumbar herniations
4/12/19
FR# 1781715 -
$3,324.19
Bilateral Upper & Lower EMG awarded to diagnose radiculopathy
4/12/19
FR# 1814873 -
$1,604.82
TPI and Ablation awarded for pain management tx
4/10/19
FR# 1808761 -
$3,001.65
Downcoding and appeal arguments rejected in favor of Petitioner, 100% awarded!
4/9/19
FR# 1815958 -
$42,846.78
EMGs, discogram, & endoscopic discectomy awarded for complex lumbar injury
4/7/19
FR# 1796552 -
$1,657.98
Future 2 level fusion w/ disc replacement awarded
4/5/19
FR# 1810340 -
$406.55
Complex causation awarded 2 level fusion, 1 level each against 2 carriers
4/1/19
FR# 1768584 -
$4,269.72
Patient who chose healthcare primary, with no h/c insurance, still entitled to full coverage
4/1/19
FR# 1810338 -
$6,624.96
ASC awarded LESI and overcomes IME defense
4/1/19
FR# 1791432 -
$1,330.46
MRO overcome and prospective L5-S1 fusion awarded
3/23/19
FR# 1781229 -
$12,580.16
ASC successfully challenges improper Healthcare Primary payment
3/18/19
FR# 1810108 -
$2,307.23
Proposed 2 Level Cervical Fusion awarded
3/15/19
FR# 1776073