Texas Prompt Payment Act Lawyer | Medical Provider Claims

It is estimated that insurance companies have wrongfully denied and delayed approximately $8 billion in payments to Texas medical providers. These delayed and denied payments have allowed some insurance companies to make large profits at the expense of hard-working medical providers. In response to these practices, Texas enacted the Texas Prompt Payment Act, which allows medical providers, including hospitals, pharmacies, clinics, and physicians, to seek payments and penalties from insurance companies that wrongfully deny or delay payment.

Texas Prompt Payment Lawyer Jason S. Coomer represents medical providers in seeking prompt payments from insurance companies via business litigation. For more information, contact Texas Prompt Payment medical provider lawyer Jason Coomer or call 866-474-1477.

Seeking Prompt Payment From Insurance Carriers

Insurance carriers that violate prompt pay laws and miss the deadlines for paying or responding to health care provider claims may be held liable for penalties for being late. For hospitals and physicians, the late penalties can begin within 45 days of receipt of a clean claim submitted non-electronically and within 30 days of receipt of a claim submitted electronically. For pharmacies, the late penalties can begin within 18 days of electronically submitted bills.

The penalties for late payments include a fifty percent (50%) penalty of the difference between the provider's billed rate and its contracted rate if the payment is 1 to 45 days late, and a one-hundred percent (100%) penalty of the difference if the payment is 46 to 90 days late. There are also provisions that allow an eighteen percent (18%) late fee and attorney's fees to be collected on any late-paid bill.

Protection for Medical Providers From Retaliation

Some medical providers have been reluctant to seek assistance in collecting payments from insurance companies because of potential retaliation. However, three statutory provisions protect Texas healthcare providers from retaliation by insurers or pharmacy benefit managers: Texas Insurance Code § 843.281, § 1301.066, and 28 Texas Administrative Code § 11.901(a)(2).

Why Choose Jason Coomer for Your Prompt Payment Act Claim

Texas business lawyer Jason Coomer handles business lawsuits and commercial litigation, including real estate disputes, construction disputes, breach of contract claims, business fraud claims, partnership breakups and business dissolutions, shareholder claims, breach of fiduciary duty claims, ownership and joint venture disputes, commercial development disputes, and intellectual property disputes. He represents clients through negotiations, arbitrations, mediations, and trials, and is admitted to practice in all Texas state courts and in federal court for the Western District of Texas.

In coordinating efforts with other Texas business litigation lawyers, Jason Coomer is able to assist businesses throughout Texas. Through business litigation teams, he has protected clients from aggressive business litigation attorneys, including millions of dollars in assets and future profits for an investment group that owns a large commercial development, and has helped obtain large multimillion-dollar recoveries.

If you need a Texas business litigation attorney for a Texas Prompt Payment Act claim or other business litigation matter, contact Texas business litigation lawyer Jason Coomer. Call 866-474-1477 (toll free).