News

what we've done lately.

After commencing arbitration, sb2 recovers $1.6 mm from MCO for two of client’s behavioral healthcare facilities.

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sb2 successfully fends off MCO’s attempt to unilaterally change daily rate for skilled nursing care, saving client approximately $11,000 per day.

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sb2 uses proprietary strategy to recover $917,194.00 from MCO for long time client.

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Prior to hearing on appeal filed by sb2, county agrees that resident was in fact a resident of that state even though she still owned a home in another.

12/01/2022

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sb2 uses CMS regulations and constitutional arguments to unwind penalty period, recovering $120k for longtime client.

11/28/2022

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sb2 uses CMS complaint letter to force MCO to properly determine residents’ actual Medicaid eligibility date.

11/22/2022

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After commencing arbitration, MCO and sb2’s client settle, with sb2 recovering nearly $1.5 mm of $1.6mm and securing a new provider agreement.

11/16/2022

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sb2 recovers 93% of pending unpaid claims and secures corrected billing practices after settling arbitration with MCO.

11/08/2022

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sb2 appeals resident’s Medicaid approval to cure coverage gap for longtime client and wins.

11/03/2022

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sb2 uses federal action to open admit pack denied in ‘19 and secure Medicaid payment for longtime IL client.

11/01/2022

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sb2 secures an UHW for current resident who allegedly transferred assets prior to admission for Medicaid planning purposes.

10/24/2022

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sb2 uses MCO’s dispute resolution process to secure payment from it for erroneously denying a number of claims.

10/18/2022

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For large provider, sb2 uses CMS administrative complaint to clear backlog of scores of pending Medicaid applications and reduces waiting period from 90+ to 30 days.

10/13/2022

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County grants full Medicaid retroactivity after sb2 files appeal challenging effective date.

10/11/2022

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