Recent Victory Against Private Payer

Nelson Hardiman scored a recent victory against private payer overreaching when it beat back an insurance company’s attempt to recoup payments totaling nearly one million dollars from two Los Angeles internists. The insurance company’s first tactic was to claim the services were not medically necessary, despite having authorized them repeatedly. Faced with Nelson Hardiman’s legal arguments and medical opinions from experts in the field, the company dropped this approach and moved onto a second tactic: claiming it had overpaid based on its own policy limitations. Nelson Hardiman mounted a vigorous response to this claim, and a month later, the insurance company wrote to confirm that it would be dropping the matter entirely.