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 uses state and federal regulations to qualify current resident back to Jan ’23 without producing requisite financial verification or spending down excess resources.
12/19/2023
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sb2 uses prehearing conference with ALJ to persuade county to open resident’s denied Medicaid application for failing to comply with federal regulations.
12/14/2023
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Using CMS regulations and the ADA, sb2 qualifies current resident for Medicaid back to Feb ’23.
12/11/2023
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For longtime client, sb2 wins UHW Request based on resident’s alleged transfer of assets for less than fair consideration & solely for Medicaid planning purposes.
12/07/2023
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sb2 quickly settles significant recoupment appeal, so client can timely close on sale of skilled nursing facility.
12/05/2023
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After ALJ agrees with sb2 that availability and not ownership determines countability of assets, county opts to grant pending Medicaid application, with full retroactivity, instead of appealing.
11/30/2023
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Using strategies highlighted in last month’s Virtual Conference, sb2 gets MCO to pay 3-year-old denied claims totaling $37.5k that weren’t appealed by client.
11/27/2023
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True to its PHE Wind Up promises, CMS responds to sb2’s complaint by directing state to comply with the agency’s regulations, resulting in numerous Medicaid application approvals for client.
11/22/2023
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Three providers with nearly 75 facilities hire sb2 to train staff and handle Medicare/Medicaid eligibility & reimbursement issues.
11/20/2023
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ALJ agrees with sb2 and orders county to reopen resident’s application for Medicaid because caseworker failed to comply with CMS assistance regulations.
11/14/2023
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Employing equitable trust, sb2 takes control of real estate sale proceeds to compensate client over $30k for skilled nursing services rendered to deceased resident.
11/08/2023
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