This is a 2014 case wherein the provider was grossly under-reimbursed.  The billed charges were $28,500.00 and the insurance company paid $2,533.39.  The provider filed appeals, but did not receive any additional payments.  The file was then forwarded to The Howard Group at which point the appeals process had expired. Nevertheless, the group filed member appeals and ultimately received an additional payment for the provider in the amount of

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This is a 2014 case wherein the primary charges were $30,735.00.  The case was forwarded to The Howard Group after the provider’s claim was denied as “the authorization for the service was not approved”. The Howard Group appealed twice claiming that the provider did obtain authorization, as well as the fact that the doctor provided services to the patient who presented initially through the emergency room. The Howard Group obtained 90% of billed charges for

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