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There's a good chance that insurers are paying you less than— or later than— what the state-legislated fees for services dictate.

There's a good chance that insurers are paying you less than— or later than— what the state-legislated fees for services dictate.

HOW CAN THIS HAPPEN?

In 45 of the 50 United States, there are state-established fee schedules specific to WC. Often, however, providers are paid less than what they have invoiced (according to the fee schedule) and documented for insurance payers (whether the insurance company or third-party payers, TPPs). This chronic pattern has three main causes:
  1.  The medical provider is participating (perhaps unknowingly) in network agreements that accept discounts that can attract more patients for treatment by being part of their “network.” However, employers, not insurers, determine who is on the approved panel of ATPs for workers who are injured. The insurance companies and TPPs have no way of promoting volume for WC claims, and the agreed-to discounts should not apply to WC. The underpayment is not noticed by the practitioners’ business office; this may be due to 
  2. The underpayment is not noticed by the practitioner’s payment processing issues, or simply because of the pressure to process an overwhelming volume of payments received. 
  3. The payers are following the “Do Rule,” i.e., do something until you are told you cannot. They boldly underpay (or delay payment); since the providers do not challenge them.

WHAT CAN YOU DO ABOUT IT?

The Med+Law Solutions, LLC. methodology addresses each of these three root causes by:
  1. Reviewing existing contracts and determining what corrective action is needed. 
  2. Providing customized reports (programmed for the top five medical billing systems) to identify the extent of the non-payment and underpayment problems. 
  3. Determining how much is due to the provider, including penalties, and taking action accordingly (e.g., rebill, reinvoice, pursue legal action). 
To help providers create processes to sustain these best practices, Med+Law Solutions, LLC.  also offers training for employees and ongoing contract review.

OUR MISSION

The mission of Med+Law Solutions, LLC. is to assure that the authorized treating physician (ATP) and associated medical service providers receive complete and correct compensation for the care of Workers’ Compensation (WC) injuries. We have combined legal, medical, and business expertise about WC to create a methodology and range of service offerings that have demonstrated significant results. Our business model is based on generating substantial financial gain for the providers, yet leaving them with little downside risk, creating a compelling unique selling proposition.

ABOUT US

John D. Christy, Attorney & Owner

John is married to the former Marsha Lynn of Dublin Georgia and they are the proud parents of twin boys and two precious granddaughters. John has a state wide law and mediation practice centered in Perry and Macon, Georgia concentrated in the areas of Workers’ Compensation, Personal Injury, and Alternative Dispute Resolution. He frequently mediates workers' compensation claims and other types of disputes throughout the state and is licensed as a mediator by the Georgia Supreme Court Commission on Dispute Resolution. 


John is a current member of the Board of Directors of the WCCL section of GTLA, is a former Chairman of the Executive Committee for the Workers’ Compensation Section of the State Bar of Georgia and has served on the Chairman's Advisory Council Medical Committee. John is a former United States Bankruptcy Trustee and he has been recognized by Super Lawyers in 2012, 2014 2015, 2016, 2017 and 2018 and is AV rated by Martindale-Hubbell.

Sean Christy, Attorney & Owner

A partner at Bryan Cave Leightonn Paisner, Sean is a trusted business and legal advisor to many public and privately held companies in complex business process outsourcing (BPO) and information technology outsourcing (ITO) transactions; strategic IT products and service; software licensing, maintenance and development agreements, including software as a service (SaaS) and cloud computing arrangements; internet related and other technology based service agreements; and other strategic procurements.


He represents clients in their most critical strategic initiatives, ranging from global transactions by multinational corporations to the core business deals of early stage start up companies. Sean has substantial experience advising clients in the financial services, hospitality, consumer products, utility, energy and online data/analytics industries. 


He has represented clients across the globe, including North and South America, Europe, Asia, the Middle East and Africa.  Prior to joining Bryan Cave, Sean was a partner in the outsourcing and software systems integration practice group of another international law firm.

Thomas Herman, Attorney & Owner

Thomas is a partner with the law firm of Westmoreland, Patterson Moseley & Hinson, LLP in Macon, Ga., where he has practiced since graduating law school in 1986.  Thomas’ practice is limited to representing the injured and disabled, with an emphasis on handling workers’ compensation claims. He has extensive experience at all levels of litigation, in civil, criminal and workers’ compensation claims, having tried a significant number of jury and non-jury trials around the State, including appearances before Georgia Court of Appeals and Georgia Supreme Court. He has obtained a number of significant appellate decisions in the field of workers’ compensation that are favorable to injured workers.  


He has previously served on the Executive Committee of the Workers’  Compensation Section of the State Bar from 1999 – 2004, including serving as Chair of the Section from 2002 – 2003.  He is a member of GTLA and has served on the Board of Directors of the Workers’ Compensation Claimant’s Lawyers (WCCL) Section since 1999.   He serves on the Medical Committee of the Chairman’s Advisory Council since being appointed in 2006.  He has been inducted as a Fellow in the College of Workers’ Compensation Lawyers, and has been selected as one of Georgia’s “Super Lawyers” beginning in 2009.

K. Scott Malone, Physician, Physiatrist, & Owner

A partner with Houston Orthopedic Surgery & Sports Medicine clinic in Warner Robins, Dr. Malone is Board Certified and a Fellow of the American Academy of Physical Medicine and Rehabilitation. He is also a Fellow of the International Academy of Independent Medical Evaluators. His medical practice is primarily non-operative Orthopedics and Sport Medicine. 

He developed the Sports Medicine Outreach Program for Houston County, GA High Schools and is also a team Physician for Fort Valley State University. He has worked with the team Physician Staff of The Green Bay Packers, Berlin Thunder (NFL-Europe), The Macon Knights AFL, Troy State University, Grambling State University, Auburn University, Georgia Military College, Tampa Bay Devil Rays, Birmingham Barron’s, Macon Whoopee , Macon Blaze NBA Developmental League, and The Birmingham Bulls.  

Dr. Malone has published several articles and has given talks nationally and internationally. He is a and was selected as one of The Macon Telegraph Best in Orthopedics and Sports Medicine for the Middle Georgia Area.

ABOUT US

John D. Christy, Attorney & Owner

John is married to the former Marsha Lynn of Dublin Georgia and they are the proud parents of twin boys and two precious granddaughters. John has a state wide law and mediation practice centered in Perry and Macon, Georgia concentrated in the areas of Workers’ Compensation, Personal Injury, and Alternative Dispute Resolution. He frequently mediates workers' compensation claims and other types of disputes throughout the state and is licensed as a mediator by the Georgia Supreme Court Commission on Dispute Resolution. 


John is a current member of the Board of Directors of the WCCL section of GTLA, is a former Chairman of the Executive Committee for the Workers’ Compensation Section of the State Bar of Georgia and has served on the Chairman's Advisory Council Medical Committee. John is a former United States Bankruptcy Trustee and he has been recognized by Super Lawyers in 2012, 2014 2015, 2016, 2017 and 2018 and is AV rated by Martindale-Hubbell.

Sean Christy, Attorney & Owner

A partner at Bryan Cave Leightonn Paisner, Sean is a trusted business and legal advisor to many public and privately held companies in complex business process outsourcing (BPO) and information technology outsourcing (ITO) transactions; strategic IT products and service; software licensing, maintenance and development agreements, including software as a service (SaaS) and cloud computing arrangements; internet related and other technology based service agreements; and other strategic procurements.


He represents clients in their most critical strategic initiatives, ranging from global transactions by multinational corporations to the core business deals of early stage start up companies. Sean has substantial experience advising clients in the financial services, hospitality, consumer products, utility, energy and online data/analytics industries. 


He has represented clients across the globe, including North and South America, Europe, Asia, the Middle East and Africa.  Prior to joining Bryan Cave, Sean was a partner in the outsourcing and software systems integration practice group of another international law firm.

Thomas Herman, Attorney & Owner

Thomas is a partner with the law firm of Westmoreland, Patterson Moseley & Hinson, LLP in Macon, Ga., where he has practiced since graduating law school in 1986.  Thomas’ practice is limited to representing the injured and disabled, with an emphasis on handling workers’ compensation claims. He has extensive experience at all levels of litigation, in civil, criminal and workers’ compensation claims, having tried a significant number of jury and non-jury trials around the State, including appearances before Georgia Court of Appeals and Georgia Supreme Court. He has obtained a number of significant appellate decisions in the field of workers’ compensation that are favorable to injured workers.  


He has previously served on the Executive Committee of the Workers’  Compensation Section of the State Bar from 1999 – 2004, including serving as Chair of the Section from 2002 – 2003.  He is a member of GTLA and has served on the Board of Directors of the Workers’ Compensation Claimant’s Lawyers (WCCL) Section since 1999.   He serves on the Medical Committee of the Chairman’s Advisory Council since being appointed in 2006.  He has been inducted as a Fellow in the College of Workers’ Compensation Lawyers, and has been selected as one of Georgia’s “Super Lawyers” beginning in 2009.

K. Scott Malone, Physician, Physiatrist, & Owner

A partner with Houston Orthopedic Surgery & Sports Medicine clinic in Warner Robins, Dr. Malone is Board Certified and a Fellow of the American Academy of Physical Medicine and Rehabilitation. He is also a Fellow of the International Academy of Independent Medical Evaluators.  His medical practice is primarily non-operative Orthopedics and Sport Medicine. 


He developed the Sports Medicine Outreach Program for Houston County, GA High Schools and is also a team Physician for Fort Valley State University.  He has worked with the team Physician Staff of The Green Bay Packers, Berlin Thunder (NFL-Europe), The Macon Knights AFL, Troy State University, Grambling State University, Auburn University, Georgia Military College, Tampa Bay Devil Rays, Birmingham Barron’s, Macon Whoopee , Macon Blaze NBA Developmental League, and The Birmingham Bulls.  


Dr. Malone has published several articles and has given talks nationally and internationally. He is a and was selected as one of The Macon Telegraph Best in Orthopedics and Sports Medicine for the Middle Georgia Area.

CONTACT US

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