What Exactly Can We Do For You?

Every case is different, but depending on your situation, we will

• Speak directly to your insurance company's decision-makers to gather relevant facts, clarify misinterpretations, correct coding and other errors, and provide documentation supporting your right to payment and/or medical services;
• Work with your doctors' and other medical providers' offices to obtain documentation and other information necessary to prove that your claim is covered and reimbursable, or that a denied treatment is medically necessary and otherwise reimbursable;
• Back up physicians' statements with any recognizable proof of claim and/or treatment validity, documentary and otherwise;
• Communicate consistently with insurance company, in writing and by telephone, to obtain reimbursements and approvals, including appropriate follow-up;
• Assist clients in preparation and submission of internal appeals with insurance companies in order to get a previous decision reversed, including appeal organization, record-keeping and preparation of documentation;
• Provide professional letter writing;
• Appeal on client's behalf to State-sponsored external review procedure, where available and appropriate;
• File complaint with State Insurance Department on client's behalf, where available and appropriate;
• File Complaint with State Attorney General's Office (Healthcare Bureau) on client's behalf, where available and appropriate;
• Seek Assistance from State- or City-funded Managed Care Consumer Assistance Program on client's behalf, where available and appropriate; and/or
• File complaints on client's behalf with other available and appropriate public and/or private entities.

Healthcare Watchdog does not provide legal services of any kind, nor does it make personal appearances. In addition, not all of the above services will be provided in every instance. Healthcare Watchdog will determine, in each instance, which of the above services are appropriate to the ultimate goal of obtaining reimbursement of a claim, or approval of a particular treatment or doctor's services.