Denials Management & Dispute Resolution

Wolfe | Pincavage regularly assists its provider clients with maximizing recovery of underpaid and denied healthcare claims.  Our attorneys regularly challenge the implementation and application of health plan payment policies.  We administratively appeal and contest reimbursement issues that create large scale underpayment trends for both in-network and out-of-network providers. 

We leverage the strength of our sophisticated managed care litigation department to resolve disputes without resorting to litigation or arbitration.  Our ability to successfully take any dispute the distance requires health plans to meaningfully engage in pre-litigation dispute resolution procedures.  The result is that we have successfully resolved millions of dollars in complex denials and underpayment trends, as well as, health plan audits and overpayments.

Our denials management team also assists clients in defending against health plan audits and recoupment activity.  Our attorneys have successfully reduced and eliminated overpayment demands, and in some cases have recovered money for clients in response to an overpayment demand.

We also have experience challenging government denials and have pursued administrative appeals for Medicare, Medicaid, and Tricare claims.  

Back to Healthcare