Q: single case agreement not honored by health insurance company
I'm a health care provider. Several years ago I received a single-case agreement on a client. When I billed for services rendered under that agreement I was repeatedly denied for various reasons that were not applicable to the single case agreement. 20 sessions remain unpaid. This was in 2016. I was never able to get this resolved with the company. I still have the paperwork supporting this. Is there any recourse or a lawyer who could help me with this?
A:
An Ohio attorney could advise best, but your question remains open for three weeks. But it would probably be difficult for ANY attorney to advise meaningfully based on the brief description here. An attorney would likely need to see the agreement, the treatments rendered, basis for denials (medical necessity, supporting documentation, etc.), and remedies outlined in the agreement or the policy - arbitration, appeal, civil court, etc.
You ask if an attorney could help with the matter. It could be difficult for attorneys to reach out to you here. The format here is not like an attorney referral service. You could search for attorneys on your own, or use the tab above (Find-a-Lawyer). The timeline running back to 2016 could present issues, but see what an Ohio attorney says, and whether it may be viable and cost-effective to pursue the matter. Good luck
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