Litigation/Arbitration Support

We take the complexity and uncertainty out of your damages claim by providing full claim set analysis and evaluation, including independent claim pricing for all product lines (Commercial, Medicare, Medicaid, etc.), detailed calculation of damages (including interest and penalties where applicable), categorization and description of underlying issues, document procurement and citation, detailed reports, and expert testimony. Our combined 75+ years of experience with hospital and payer revenue cycle processes allows us to distill voluminous and often confusing documentation into a comprehensive, concise, and understandable narrative.

Remibursement and DAMAGES analysis

If your hospital or health system is contemplating arbitration or litigation with a payer, 221Consulting can provide underpayment identification, denial root cause analysis, aggregation and categorization of existing claim sets, and assistance with pre-litigation/ arbitration strategy.

 

Based on our deep experience with payer-provider claims disputes, we can assess the strength of the case based on issues identified, contractual language, documentation strength, and applicability of state and federal regulations. We can support or assist in Meet & Confer, mediation, or other pre-litigation activities, as well as provide administrative support for procuring necessary documents for litigation.

Payment recovery and

Revenue cycle consulting

Based on our years of working closely with hospital Finance, Patient Financial Services, and Managed Care personnel on billing, coding, contract, and collection issues, we are in a unique position to provide valuable consulting expertise to revenue cycle operations.

 

We specialize in underpayment identification and recovery on zero-balance accounts across all product lines, denial recovery and root-cause analysis, and revenue recovery acceleration for open balance claims.