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Practice Areas

Insurance Accounts Receivable Claims and Legal Services

At Charles J. Hilton & Associates, P.C. we provide full-service insurance accounts receivable collection services. We can represent healthcare clients nationwide assisting with the resolution of unpaid, underpaid, and delayed healthcare payer reimbursement in accordance with the multi-jurisdictional rules of practice of that particular state.

Our team of attorneys and paralegals are prepared to represent your facility when you encounter Denials, Underpaid Claims, Stop Loss Delays, and ERISA Plans.

Denials

We are available to assist with:

Workers’ Compensation Denials
Automobile Claims and Denials
ERISA Self-funded Plan Denials
Commercial Insurance
Medicare/Medical Assistance
Medical Necessity
Veteran’s Administration Claims
Subrogation Issues and Delays
EMTALA and Emergency Department Related Claims
Pre-Existing Conditions
Diagnosis Code Denials
No Surprises Act

ERISA Plans and Stop Loss Delays

We are available to resolve issues resulting from:

ERISA Plan attempting to delegate its administrative and fiscal duties to process and pay claims to the Plan’s reinsurer or Stop Loss insurer.
Fast Communication with ERISA Plan/TPA
Providing ERISA Plan/TPA with applicable statutes and case law
Promoting timely payment without stop loss delay
Ongoing follow-up

Underpaid Claims

Are you experiencing issues with the following? Let Charles J. Hilton & Associates, P.C. assist you:

UCR
Improper Discount
Purchase Invoice Claim Reduction
Medical Necessity
Unilateral Audit
PPO Disputes
Contract Challenges
Bundling Issues

Legal Counsel

Are you seeking answers to your legal questions? We are available to answer questions you may have, and we will provide:

Legal memorandums
Advisory opinions
And/or legal analysis on a wide range of healthcare reimbursement issues
We are also available to provide consulting services and seminars for your staff
Contract suggestions
Staff education opportunities
Letter writing assistance

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