We protect members and dependents against unreasonable out-of-network and balance billings by health care and medical providers and unfair debt collection practices. Based upon post-pay review, we represent large self-funded plans and insurers to recover overpayments from medical providers.
We also represent stop-loss carriers in defense of excess liability claims. Our highly rated trial and appellate lawyers cover all stages of activity from advocacy and negotiation to jury trial and appeal
aequum by Koehler Fitzgerald LLC utilizes a proprietary database to provide customizable weekly, monthly and annual reports to our partners. Reports can include claim status, disputed amount, original billed amount, settlement amount, claims by plan or provider, and percentage of savings and recovery. Because the database is fully relational, any category of information may be tracked and reported. The reports can be specific to one plan, multiple plans, geographic region, insurance coverage, carrier or provide a general overview.
and our clients
- Self-insured health plans
- Medical cost containment companies
- Stop-loss carriers
What our partners
have been saying about
Jim Farley, J.P. Farley Corporation
We engaged Koehler-Fitzgerald in 2015 to represent covered employees of health plans we provide administration to that have adopted reference based pricing. They have been very responsive to the needs and questions presented by plan sponsors, plan members, and our staff. Their success rate with balance billing issues presented to them has been in excess of 99% by any standard of measurement. Knowing that every participant has legal representation from a high quality,
experienced law firm provides our client plans and employers confidence that their employees will be properly protected from the many aggressive balance billing practices that a small portion of hospitals and other medical providers attempt to employ. They have been shown to be the most effective solution to the only real impediment to adopting reference based pricing.
Pat Sanders, Insurance Management Services, Inc.
We’ve been working with Koehler Fitzgerald for over 3 years and couldn’t be happier. They’ve always been very attentive to not only our questions but also to our client’s members who are dealing with balance billing issues.
Their knowledge and advice has been invaluable to us as a Third Party Administrator developing processes to better serve our clients and their employees in the reference based pricing arena.