ERISA LAWYER ??

Can anyone recommend a lawyer that can handle denial of payment by an employer self-insured plan that stopped paying at $2500.00 of benefits after having issued a precertification letter to the surgeon? This would be ERISA related, we have been told that the state insurance department would have no jurisdiction.

before you take on the expense of an attorney, make sure you read the letter, as well as a very DETAILED reading of the plan documents (not the summary that you get when you enroll, a copy of the full plan). If it says that precertification does not necessarily mean that you will in fact have coverage, or if the plan outlines potential limits to the payment, you won't have a claim, and will spend more than you owe in legal fees to no avail. A lot of times hospitals will reduce what you owe if you write a well reasoned, and pathetic sounding letter. They charge off a lot of stuff every year, and I've seen some bills get outright discharged. Be advised that if this happens, it may be imputed as income. This is not legal advice, just a few suggestions. Good luck

Great advice already given...

If you need a lawyer with ERISA experience this guy is good and reasonably priced. Gary J. Viscio, Esq. Resnikoff & Viscio, PC 145 Willis Avenue Mineola, New York 11501 (516) 742-5300 Fax (516) 742-8130 [email protected]