Services We Offer
Business Formation and Buy/Sell Agreements – Simons & Associates Law provides consultation to health care providers who are starting a private practice, growing and developing their practice, bringing equity owners into their practice and selling their practice. We’ve assisted clients in writing service proposals, developing legally defensible consulting services, negotiating service contracts with facilities, and developing fitness, wellness and other services as an extension of their traditional medical practice. If you are contemplating starting practice, going out on your own as an independent contractor or consultants expanding into a new line of business or getting into a new partnership or joint venture and you need advice, call us. We can help.
Review of Payor Contracts – Contracts with private insurers are becoming more and more complicated. Many contracts are “Silent PPOs” that allow the payer to sell their preferred provider network to any other payer that the provider may already have a separate contract with. Providers can risk their business by signing every contract that comes their way without first obtaining legal counsel on what the contract really means for the provider’s reimbursement. Simons & Associates can review your provider contracts and assist you in negotiating terms that appropriately protect you as well as the Payer. We can also advise you on any compliance and billing issues that may be present in a Payer’s contract. Since we regularly review contracts for physical therapists in private practice, we may already be familiar with the contract you need to have reviewed, saving you significant legal fees!
Malpractice and Liability Insurance Consultation – Does your malpractice insurance cover the services you provide? You may be surprised to find out it doesn’t. Professional malpractice coverage may be limited to tasks that are within the profession’s scope of practice. Since practice acts vary from state to state as well as the interpretations by licensure boards, the same insurance plan could provide different coverage in different states. Non-traditional services may not be covered by your malpractice plan at all. If you need help determining whether you have the right policy for your practice, Simons & Associates can help.
Medicare Denials, Recoupments & Appeals – Medicare and Medicaid audits are on the increase. Government payers are looking for any opportunity or excuse to recoup payments already made to you for services you legitimately provided. Even harmless, minor omissions in clinical documentation in a small number of records can be extrapolated to result in a repayment demand of thousands (even hundreds of thousands) of dollars. Auditors, however, frequently make mistakes by misinterpreting or misapplying CMS rules. If you are the victim of an audit, you need legal counsel. Even if the amount being denied (or recouped) is small, it might still mean you are a target for a more comprehensive audit later. Appeal procedures are time sensitive and procedures must be carefully followed. If you try to handle your own appeal, you may neglect to present legal defenses and arguments that can get your denial reversed. If you are the victim of an audit and need legal consultation, contact Simons & Associates immediately for legal representation from a lawyer who knows health care!