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United States: Healthcare Litigators Recover Large Insurance Payments for Vibra Healthcare and Other Providers in 2021

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In November 2021, Thompson Coburn’s healthcare litigators successfully resolved another round of payment disputes for a healthcare provider without the need for legal action. In the most recent example of this highly effective payment strategy, Thompson Coburn secured large payments from the insurer for the client. Vibra Health for a collection of claims relating to the care and treatment of Vibra patients at a rehab hospital in El Paso, Texas.

The patients were all covered by the same Medicare Advantage Plan. Yet after patients received care at Vibra Rehabilitation Hospital, the insurer underpaid Vibra for its services and cited inappropriate technical grounds for its inability to properly reimburse Vibra.

Faced with repeated refusals to compensate Vibra for services rendered to covered patients, Thompson Coburn’s team notified the insurer of its breach of the parties’ agreement and of excessive underpayment and notified the insurer of its draft request for arbitration. The insurer subsequently agreed to pay the majority of the claims.

Vibra was represented by the Dallas partner Mackenzie wallace and St. Louis partner Ashton dietrich.

This case is an example of a common problem for health care providers: payers, including insurers and Medicare and Medicaid plans, who falsely deny or underpay claims. These refusals and underpayments constantly threaten the fluid revenues and the functioning of health systems.

Thompson Coburn’s National Healthcare Team has developed a very effective – and very cost-effective – approach to these types of payment disputes that allows providers to recover payments from payers. It is an important and value-added service that our lawyers have provided to healthcare providers across the country. For more information, please contact Mackenzie Wallace Partners or Jenny ecklund.

The content of this article is intended to provide a general guide on the subject. Specialist advice should be sought regarding your particular situation.

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