We built aequum because patients needed someone in their corner.
Medical bills should not be a legal battle. When they become one, aequum is the team that shows up, with the attorneys, technology, and experience to fight back.
Self-funded plans served
Savings off disputed charges
Claims handled
2015
The Practice Takes Shape
The healthcare billing system is broken in a very specific way. Providers send patients bills for two, three, sometimes ten times what the care was worth. Most people pay. They do not know they can push back. And most of the time, nobody does it for them.Jim Koehler saw this problem up close and recognized it for what it was: a legal problem disguised as a paperwork problem. In 2015, he launched what would become aequum as a legal practice focused entirely on balance billing defense. The idea was to bring real litigation strength to a space where most patients had none."aequum" comes from the Latin word for fair and just. That is not a coincidence.The practice grew fast. Demand from self-insured health plans and TPAs across the country had made it clear this service was needed and valued. And, so, in 2020, aequum LLC was formally incorporated, a technology-driven company purpose-built to defend plans and their members at every stage of the medical billing process.
The system rewards patience. Ours, specifically.
Medical providers know most balance billing claims go unchallenged. The bills arrive and people pay them, because fighting back takes time, knowledge, and access to attorneys that most people do not have.aequum exists to change that math. We built a proprietary system that tracks every claim from the moment it arrives to the moment it is resolved.We paired that technology with attorneys who have tried hundreds of cases in state and federal courts. We added an ERISA specialist with four decades of experience in plan design and federal compliance.The result is a team that can fight this battle across every front: administrative advocacy, negotiation, litigation, appeal. Wherever a medical provider or debt collector tries to take it, we go there too.Our partners come to us because of what we have proven: when someone qualified actually shows up, the outcomes improve. Not luck. What happens when legal firepower meets purpose-built technology.ERISA Counsel, aequum
Technology runs the system. Attorneys win the cases.
aequum is not a call center. It is not a negotiation service. It is a tech-backed legal operation built to handle every stage of a balance billing dispute, from the first notice through jury trial and appeal.Proprietary Case Management
Every claim runs through a fully relational database that integrates with document automation, calendaring, and reporting. Nothing falls through the cracks, and every partner gets the visibility they need.Administrative Advocacy
We step in the moment a plan member receives an unreasonable bill. Our team coordinates directly with providers, payers, and collection agencies to challenge claims before they escalate.Litigation and Appeal
When providers push disputes into court, we are ready. Our attorneys have tried cases in state and federal courts across the country, with an appellate record spanning well over 200 appeals.Overpayment Recovery
Based on post-pay review, we partner with large self-funded plans and insurers to identify and recover overpayments from medical providers, recovering dollars that would otherwise stay lost.Reporting That Shows the Picture
Partners receive customizable weekly, monthly, and annual reports covering claim status, disputed amounts, settlement totals, and savings percentages. Partners can slice it however they need it.ERISA and Compliance Guidance
Healthcare regulations change constantly. Our ERISA counsel helps plan sponsors understand their fiduciary obligations, respond to regulatory shifts, and build plans that protect both the employer and the employee.People who have done this work for a long time.
aequum was built by attorneys and benefits experts who came up in the trenches of complex commercial litigation and federal employee benefits law. This is not a consulting practice that wandered into healthcare. This is what we do.Jim founded two law firms and an online testing company before launching this balance billing defense practice in 2015. He saw patients getting crushed by billing practices that were legally questionable and rarely challenged, and built something to change that.
J.D., Case Western Reserve University, Order of the Coif. Ohio Super Lawyer 2010 to 2023. Best Lawyers in America. AV Preeminent by Martindale-Hubbell.
Christine leads aequum as CEO. She came to the practice as an IP litigator with large law firm experience and a genuine fluency in technology. Under her leadership, aequum has grown to serve more than 500 self-insured health plans across all 50 states.
J.D., cum laude, Boston University School of Law. Ohio Super Lawyers Rising Star. Ironman triathlete and volunteer for the Legal Aid Society of Cleveland.
Jack spent twenty-five years running the benefits function at a Fortune 100 corporation. Very few ERISA attorneys have actually managed the plans they now advise on. Jack has, and that perspective shapes everything he does here.
L.L.M., John Marshall Law School. J.D., South Texas College of Law. Certified Employee Benefits Specialist. Benefits Manager of the Year, Business Insurance Magazine, 2008.
Trusted Across the Self-Funded Market.
Their success rate with balance billing issues presented to them has been in excess of 99% by any standard of measurement. They have been shown to be the most effective solution to the only real impediment to adopting reference based pricing.
We have been working with aequum for over 3 years and could not be happier. Their knowledge and advice has been invaluable to us as a Third Party Administrator developing processes to better serve our clients and their employees.
aequum's expertise in balance billing disputes and IDR proceedings strengthens the foundation of the pricing solutions we deliver at ClaimsBridge. Their ability to navigate complex regulatory frameworks while driving practical outcomes makes them a trusted and highly valued partner in the self-insured market.