In 1999, I landed a job at a claims repricing firm. I was new to the insurance industry but was eager to learn. However, the deeper I dug, the more I realized something was terribly wrong. The firm I worked for was engaged in what's known as silent PPO fraud--a practice where providers' private, in-network contracted rates are accessed without their consent and fraudulently applied to their out-of-network claims. In short, healthcare providers were being cheated--and I watched it happen every day.
I witnessed doctors and clinics, often small practices, devastated by the unexpected claim reductions. I heard their voices break in frustration and anger over the phone. They were being taken advantage of, and our firm had an entire department dedicated to defending those unjust discounts. It didn't matter if the discounts were fraudulent--our policy was to never reverse them.
After three years, I couldn't take it anymore. I walked away from the best-paying job I ever had, knowing I had to do something different--something honest.
I launched my own business to offer a transparent alternative to the claims repricing industry: negotiated out-of-network claim settlements, where providers had a voice and knew exactly what to expect. No hidden deductions. No silent PPO repricing. Just fair, upfront agreements. And for a while, it worked. But honesty doesn't always win in a system that rewards deeper discounts. Because payers prioritized the deeper discounts they could take through silent PPO arrangements over fair negotiated agreements, I eventually lost my last client--and ultimately, my business.
As I always do when facing uncertainty, I turned to God in prayer--seeking His guidance for what to do next. In response, He gave me a vision: I saw a doctor clenching insurance claims in both hands, shaking them in frustration because he couldn't get the insurance payers to pay what they were supposed to. At that moment, I felt his struggle--and I knew with complete clarity: this is what I'm called to do.
Since then, I've dedicated myself to helping healthcare providers recover what they're rightfully owed. I've studied the ins and outs of ERISA, state and federal regulations, and the countless ways insurance payers try to bend the rules. I've learned how to push back--how to advocate, how to fight, and how to win.
This is my mission, not just a business.
I know the battle you're facing: relentless underpayments, unjust denials, and a payer system designed to wear you down. I've seen the system from the inside, and now I'm using everything I've learned to fight for those who deserve better: independent healthcare providers like you, who are doing good in this world and getting shortchanged for it.
You shouldn't have to battle insurers just to get paid for your work. That's what I'm here for.
Why You Need an Advocate in Your Corner
Independent practices are the backbone of our healthcare system. You offer personalized, hands-on care, build trust with patients, and fill critical gaps that large healthcare systems can't. But while you're focused on patient outcomes, insurance payers are focused on minimizing payouts--and they have entire departments dedicated to doing just that.
This is where the imbalance begins. Unfair claim denials, underpayments, delayed reimbursements, silent PPO discounts, recoupment threats--these aren't random flukes. They are systemic strategies designed to overwhelm providers, delay payments, and quietly reduce what you're rightfully owed. And the truth is: you're not just treating patients anymore--you're also in a financial tug-of-war with insurance payers who know the rules better than you do. That's why having an experienced advocate on your side isn't just helpful--it's essential.
I bring over two decades of knowledge and regulatory expertise to level the playing field. I specialize in leveraging ERISA law, state and federal protections, and payer accountability measures to recover denied and underpaid claims and protect your practice from recoupment abuse. I don't just submit appeals--I build defensible cases, push back with precision, and pursue every available path to maximize your reimbursements.
I'm not here to submit paperwork and hope for the best--I'm here to strategically fight back against unfair claims practices, and get results.
You've worked too hard to let revenue slip through the cracks because of payer tactics built to wear you down. You don't need to become a legal expert or spend hours arguing with payers.
You just need someone who knows how to fight back--and win. Let me be that advocate for you.
Understanding The Power of ERISA
ERISA, the Employee Retirement Income Security Act, is a federal law that primarily governs employer-sponsored benefit plans, including health insurance. It sets guidelines for plan administration and includes provisions for the appeals process when claims are denied or underpaid. ERISA plays a significant role in healthcare claims as approximately 83% of commercial-managed healthcare plans fall under its jurisdiction, rendering them exempt from most state insurance regulations.
This means that the appeals process for ERISA health claims follows a different set of rules, often unfamiliar to healthcare providers and billers. It's crucial to understand and leverage ERISA regulations to recover denied or underpaid medical claims and successfully secure the payments healthcare providers deserve. That being the case, my unwavering dedication to aiding independent practices in dealing with these challenges and leveraging ERISA regulations sets the stage for successful claim recovery and securing rightfully earned full medical claim payments.
Discover how ERISA empowers healthcare providers to fight back. Details are at the bottom of this page.
Why Choose My Services?
Unlike most revenue recovery vendors who primarily address contractual and billing errors, I specialize in successfully challenging and overturning payers' unfair claim reduction/denial tactics. Also unlike most other vendors, I efficiently utilize ERISA, along with federal and state laws, to capture proper and full payer reimbursements. So while other revenue recovery providers prioritize hospitals and large health systems for their lucrative potential, my passion lies in championing the underdog--small independent practices. I am dedicated to unlocking uncollectible revenue and securing financial success for those who often get overlooked. And my revenue recovery service fees are contingent on successful recovery. I only get paid when you get paid.
With a relentless focus on helping smaller practices thrive, I offer unparalleled expertise and personalized solutions to ensure your rightful share of revenue is recovered, propelling you toward lasting prosperity.
Secure Your Rightful Revenue Today
Don't let payers' unfair claim reduction/denial tactics hinder your practice's financial potential. Whether it's navigating the complexities of ERISA or challenging unjust claim practices, I'm here to help you secure the compensation you rightly deserve. Contact me today to take control of your revenue, ensure your financial success, and empower your practice for a thriving future. Click here and start reclaiming your rightfully earned compensation.
