If your medical practice was underpaid for out-of-network services, your case may fall under the No Surprises Act and its Independent Dispute Resolution (IDR) process — a system meant to protect patients, but one that insurers often use to suppress physician reimbursement. At Kotlar Cohen, we help physicians and medical groups navigate the process from start to finish, challenge unfair payment tactics, and pursue the full value of your work. In the end, we do our best to take as much administrative and financial pressure off your plate as possible by recovering the payments you deserve.

The No Surprises Act was created to stop patients from getting unexpected bills for emergency care or out-of-network services at in-network facilities. Those protections matter. But the IDR process that followed has become complicated, rigid, and, in practice, tilted toward insurers unless it’s handled with precision. Payments come in lower than market reality, negotiations stall, and practices are left doing extra work for less reimbursement.

When you’re already stretched thin, chasing underpaid claims becomes a drain: revenue goes down, overhead stays the same, and your team spends hours navigating timelines, portals, batching rules, and evidence requirements — all while insurers rely on artificially low Qualifying Payment Amounts (QPAs) to justify reduced offers. The financial impact adds up quickly, especially for hospital-based and emergency specialists whose services are frequently subject to NSA arbitration.

That’s where we come in. Our team identifies which claims qualify for IDR, chooses cases with strong recovery potential, and builds compelling evidence packages that show the true value of your services. We strategically batch similar claims to maximize recovery while minimizing fees, and we apply the most current court-driven regulatory standards to strengthen your leverage throughout the process.

If your medical practice treated patients injured in motor vehicle accidents and was underpaid or denied reimbursement, your claim may fall under Personal Injury Protection (PIP) laws. These claims are intended to ensure prompt payment for medically necessary care, yet insurers frequently use technicalities, aggressive reductions, and delay tactics to avoid paying the full value of your services. At Kotlar Cohen, we help physicians and medical groups enforce their rights under PIP statutes and pursue proper reimbursement from start to finish.

PIP regulations vary by state and are often highly procedural. Insurers scrutinize documentation, apply fee schedules inconsistently, and deny claims based on alleged medical necessity, coding issues, or paperwork defects — even when treatment was appropriate and timely. What should be a streamlined payment process instead becomes an obstacle course that shifts the financial burden onto providers.

For practices already operating under tight margins, unpaid or underpaid PIP claims can quietly erode revenue. Staff time is consumed by resubmissions, follow-ups, and appeals, while payments are reduced or withheld altogether. When benefits are exhausted or improperly cut off, providers are often left absorbing the loss.

That’s where we step in. Our team evaluates PIP claims for compliance and recovery potential, challenges improper reductions and denials, and pursues payment through appeals, negotiations, and enforcement actions where necessary. We handle the administrative and legal pressure so your practice can focus on patient care — not chasing insurers for money you’re owed.

If your practice provided care for a work-related injury and reimbursement has been delayed, reduced, or denied, your claim may fall under Workers’ Compensation laws. While these systems are designed to cover medical treatment for injured employees, carriers frequently dispute authorization, apply fee schedules narrowly, or delay payment altogether. Kotlar Cohen helps healthcare providers navigate these rules and recover revenue that is often wrongfully withheld.

Workers’ Compensation claims are governed by state-specific regulations that dictate everything from billing timelines to reimbursement rates and medical necessity standards. Insurers and third-party administrators routinely exploit these rules — disputing treatment plans, questioning referrals, or citing technical noncompliance to justify nonpayment.

The result is a growing administrative burden on medical practices. Payments arrive late or not at all, staff spend hours coordinating with carriers and employers, and cash flow becomes unpredictable. Over time, these unresolved claims create real financial strain, especially for practices that regularly treat injured workers.

Our team works to level the playing field. We verify coverage, address authorization and fee schedule disputes, and pursue underpaid or denied claims through the appropriate administrative and legal channels. By applying deep regulatory knowledge and strategic pressure, we help ensure that Workers’ Compensation carriers meet their obligations and that your practice is compensated fairly for the care it provides.

PIP regulations vary by state and are often highly procedural. Insurers scrutinize documentation, apply fee schedules inconsistently, and deny claims based on alleged medical necessity, coding issues, or paperwork defects — even when treatment was appropriate and timely. What should be a streamlined payment process instead becomes an obstacle course that shifts the financial burden onto providers.

For practices already operating under tight margins, unpaid or underpaid PIP claims can quietly erode revenue. Staff time is consumed by resubmissions, follow-ups, and appeals, while payments are reduced or withheld altogether. When benefits are exhausted or improperly cut off, providers are often left absorbing the loss.

That’s where we step in. Our team evaluates PIP claims for compliance and recovery potential, challenges improper reductions and denials, and pursues payment through appeals, negotiations, and enforcement actions where necessary. We handle the administrative and legal pressure so your practice can focus on patient care — not chasing insurers for money you’re owed.