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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sb2 convinces ALJ to open husband & wife’s denied Medicaid applications based on unavailability of missing verification.
10/19/2020
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In another first, sb2 convinces NC administrative law judge that PL (resident share) must be reduced to account for alimony payments.
10/12/2020
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After extensive litigation, which included an important appellate court win, sb2 qualifies resident for Medicaid back to June ’18.
10/05/2020
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sb2 uses recent appellate court win on unavailability of resources to qualify resident back to September ’19.
09/30/2020
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For provider with multiple facilities, sb2 reduces state Medicaid recoupment amount by $1.75 million.
09/23/2020
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Acute care provider agrees to cover resident’s stay at client’s facility based on failure to obtain MCO authorization before referring.
09/17/2020
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Agreeing with sb2, arbitrator denies national MCO’s motion to dismiss complaint seeking $2 mm for defective claim processing system.
09/14/2020
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sb2 uses CMS regulation to qualify resident back to January ’18.
09/08/2020
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sb2 uses CMS Regulations and federal court precedent to qualify current resident back to March ’18.
08/25/2020
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sb2 uses obscure state regulation to win two administrative law appeals for incapacitated residents.
08/17/2020
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MCO agrees with sb2 to waive all missed claim dispute + appeal deadlines dating back to execution of contract with client.
08/13/2020
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