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, ERISA Plans and Stop Loss Delays, Underpaid Claims, and with Legal Counsel. For examples of accounts we have handled, please see below.

Denials We are available to assist with: Worker’s 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

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