The Case of the Emergency Room NSA Claim

HHC clients turn to us to avoid the laborious, time-consuming, uncertain, potentially costly, Independent Dispute Resolution process for claims covered under the No Surprises Act. Upon receipt of this out of network emergency room claim our client sent us the claim and asked us to work to achieve a settlement with the provider. Within 3 days the Case Manager determined the appropriate amount to pay, found and negotiated with the provider decision maker, and secured a 52.2% reduction in the bill.

Claim: 1517578

Provider Type: Out-of-Network Hospital

Claim Type: Emergency Room

Diagnosis: Acute maxillary sinusitis, inflammation of the paranasal sinuses caused by pollen, virus, bacteria, or fungus

List Charge: $29,271.55

Negotiated Charge: $14,000.00

H.H.C. Client Savings: $15,271.55