Callagy Law: Commercial Insurance Law firm Recovery for Out-of-Network Healthcare Providers

You’ve got to fight for your right to recovery

Let’s face it – most doctors have a stack of files they’ve just given up on.  These files contain thousands, perhaps, millions of dollars, that remain completely unpaid by insurance companies, with little to no explanation as to why.

Out-of-network doctors face a peculiar dilemma.  They’ve made a business decision to not engage in contracts with insurance companies, whether it be that they thought the contracts were too restrictive or perhaps they were not getting enough referrals to make the bargain favorable for them.  Whatever the case may be, in a free market, doctors have the choice to charge what they want for the specialized services they provide.  However, this does not mean that insurance companies have the right to unfairly deny proper reimbursement with no explanation. Healthcare providers need the experience of a Commercial Law firm to help them recover what is owed to them.

What is Major Medical/Commercial Insurance?   

“Major Medical Insurance” or what Callagy Law, along with Sean Callagy now refers to as Commercial Insurance or CI, is your primary healthcare insurance.  Callagy Law’s CI department handles these types of cases.

The Rights of Out-of-Network Healthcare Providers under ERISA (Employee Retirement Income Security Act)

ERISA is a federal law that sets minimum standards for health benefit plans in private industry, should an employer choose to set one up for its employees.  ERISA requires health benefit plans to regularly provide participants with information about the plan.  ERISA also gives participants or beneficiaries the right to sue for benefits and breaches of fiduciary duty. 

What Callagy Law is doing with ERISA that no other law firm does!

Callagy Law is doing what no other law firm does – Major Medical or Commercial Insurance is an area of law that few, if any, law firms venture to take on.  There are hardly any that pursue these claims on the level of Callagy Law and Sean Callagy.  Callagy Law has approximately 50 active clients on whose behalf we aggressively fight for in both Superior and Federal Court.  However, prior to filing any suit, Callagy Law works with doctor’s offices to ensure they are using the Assignment of Benefits and appeals required in order to properly pursue these ERISA claims.  

Callagy Law is a full service Commercial Insurance law firm! There have been several significant amendments to ERISA concerning health benefit plans which help out of network providers recover.  Callagy Law has the specific knowledge and fierce determination to pursue these claims and recover money from the files that are just sitting there! As a Commercial Insurance law firm it our job and pleasure to recover this money for healthcare providers.

Contact our office today for a complimentary evaluation or consultation concerning your Commercial Insurance needs by calling 201.261.1700 or email us at inquiries@callagylaw.com. 

A day in the life of a PIP Attorneys in New Jersey working for Sean Callagy at Callagy Law

I work as one of the PIP Attorneys in New Jersey for Sean Callagy at Callagy Law.  I love my job.  A day in my life boils down to being a crime fighter.  I catch big insurance companies lying, cheating and stealing, and I help bring them to justice.

Who am I protecting? 

Your friendly neighborhood doctors!  At Callagy Law, we have hundreds of clients, from the biggest hospitals in the state, to local “mom and pop” single doctor practices.  And every day, Sean Callagy, the New Jersey PIP Attorneys at Callagy Law, and I battle the biggest Villains in the insurance world. These Villains lie, cheat, and steal from our doctors and deny necessary medical treatment to their patients. Of course not all insurance companies are like this, however, rest assured that there are some.

How do the Villains lie, cheat and steal?

The biggest way that these Villains cheat providers out of their money is through sophisticated automated computer systems.  The bills submitted by our providers are run through automated billing computers which make hundreds, if not thousands, of mistakes every day.  When our clients appeal, trying to correct the mistakes, and recover the money they’re rightly entitled to, another computer system automatically denies them. The Villains also send patients to their own private villainous evil doctors (I’ll call them Dr. Evil for short) who deny any further medical treatment to the patients.  Dr. Evil thinks he can look at a patient for about 20 minutes, and then say that the patient has fully recovered from a car accident, even if the patient is still in 10 out of 10, excruciating agony.

Why do they do it?

Money!  Why else? 

Every day, the Villains are laughing all the way to the bank.  The bank where, by the way, they have hundreds of millions of dollars sitting in accounts earning interest.  The Villains earn SO MUCH MONEY just off the interest in these accounts, which they can afford to pay for all the arbitrations that we, the New Jersey PIP Attorneys working for Sean Callagy at Callagy Law can possibly file.

Why do we do it?

Because we know it matters.  Our clients are deeply affected by the lying, cheating and stealing done by these Villains, and Sean Callagy, the PIP Attorneys in New Jersey at Callagy Law, and I do battle for our clients every day, because when the Villains eventually put all of these doctors out of business with their lying, cheating, and stealing, who will be left to care for us?

Again not all insurance companies, and certainly not all the people who work for these companies, are as bad as others. And certainly there are doctors across the country who are deceptive and do wrong. That is why it is important to have a knowledgeable and integrity filled law firm on your side.

For more information about PIP, PIP attorneys and Callagy Law please contact us at inquiries@callagylaw.com, or call 201.261.1700.