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Health Plan Benefit Denials
 
The Geldermann Law Practice provides legal advisory and representational services to patients, physicians, and hospitals at each stage of the denial and appeals management process. We appeal denied and underpaid claims, advise clients regarding their rights and responsibilities under Federal and State laws and regulations, and provide consulting services geared toward implementing denial prevention strategies. Our goal is to ensure that physicians and hospitals are adequately reimbursed for the services they provide, and that patient-insureds receive the health insurance benefits to which they are entitled from managed care organizations. 

Services

 

Early Case Evaluation

 

When a dispute looms, litigation may not always be the ideal solution. Lawsuits can be expensive, lengthy, stressful, and distracting, and can lead to unpredicted outcomes. When a client consults a lawyer, goals as communicated by the client should be the foremost consideration in deciding whether, given sufficient advance time, the matter can be resolved short of engaging in a lawsuit. On the defensive side, lawsuits might be avoided by early assessment of the strength of a claim, communication, and negotiations that achieve outcomes acceptable to the client.

 

More specifically, clients may wish to consider dispute resolution methods alternative to litigation.  Mediation is a prime example.  Mediation is a facilitated discussion between parties with the aim of reaching a settlement of their dispute. A key feature of mediation is that the parties remain in control of the topics of discussion, documents, and the outcome throughout the entire process. While the mediator will lead the process and guide the discussion, participants are not bound to reveal any information or engage in any discussion with which they are not comfortable. Most importantly, the parties have complete control over any settlement to which they agree up until the final moment of the mediation process, when a binding and enforceable agreement can be achieved.

 

At the Geldermann Law Practice, we strive to evaluate all practical solutions that meet our clients’ needs and goals, while avoiding or truncating unnecessary lawsuits, if possible.

 

Arbitration
 
 
 
Arbitration is a process that may resemble litigation in some respects, but has stark differences.  Unlike most litigation, many arbitrations occur outside a courtroom, the person appointed to make the decision is not normally a sitting judge, procedures and evidence requirements can be relaxed, the arbitrator may apply her own expertise, and the ultimate decision is usually not appealable.

 

Arbitration is always voluntary, but the choice once made may then become a requirement.  An election to arbitrate can be made long before the dispute arises. Sometimes clients sign business agreements or other contracts that call for arbitration of future disputes.  Those contract clauses may require that the dispute or claim be arbitrated instead of brought in litigation.

 

Other times clients may find it beneficial and advantageous voluntarily and mutually to submit a disputed claim to the arbitration process in the hope that it will lead to a less costly, more expeditious mode of resolving a conflict than would litigation. 

 

The Geldermann Law Practice is available to advise and represent clients who are required to, or are considering electing to, arbitrate a dispute instead of litigating disputed claims in court.

- In General

Litigation

 

 

 

The Geldermann Law Practice will always aggressively pursue outcomes in litigation consistent with a client's lawful objectives and ethics requirements. When mutually acceptable outcomes to a dispute cannot be achieved through negotiation and consent, and a lawsuit cannot realistically be avoided, the Geldermann Law Practice is available to represent clients and seek to achieve their goals through court litigation.  The process normally begins with a complete evaluation of claims and defenses, a careful investigation into the facts, the preparation of court pleadings, potential motions practice, and may proceed to discovery and trial.  If emergencies are involved, immediate relief may be pursued if warranted. Mr. Geldermann has decades of experience handling such matters.

 

Through litigation,  the Geldermann Law Practice will seek to maximize the likelihood of achieving outcomes desired by its clients.    

Business Transactions

 

The Geldermann Law Practice offers a wide range of business transactional services, including contract drafting, review, and negotiation, company and business unit acquisitions, commercial purchase & sale documents, security agreements and U.C.C. transactions, and commercial business transactions.

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