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Summary of Services

The FIRM provides professional claims billing services for individual providers, clinics and facilities. We service all disciplines of practice, i.e., medical, dental, diagnostic testing, chiropractic, physical therapy, optometry/ophthalmology, mental health, chemical dependency, and durable medical equipment.

We offer specialty services such as consultation, collections and appeals, contracting and credentialing, verification and preauthorization and personal injury settlement negotiating. We offer form development and revision services, office reorganization and personnel training.

We have extensive experience in all areas of commercial insurance, Workers Compensation, personal injury, Third Party Administrators, Medicare, Medicaid, and other state and federally funded programs. We offer personalized services designed specifically to meet your needs.

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Obamacare Hits a Pothole

Let the Experts at The Firm Services assist your practice. NY Times - Opinion Page- Paul Krugman OCT. 28, 2016 For advocates of health reform, the story of the Affordable Care Act, a.k.a. Obamacare, has been a wild roller-coaster ride. First there was the legislative drama, with reform seemingly on the edge of collapse right up to the moment of passage. Then there was the initial mess with the website — followed by incredibly good news on enrollment and costs. Now reform has hit a pothole: After several years of coming in far below predictions, premiums on covered plans have shot up by more than 20 percent. So how bad is the picture? The people who have been claiming all along that reform couldn’t work, and have been wrong every step of the way, are, of course, claiming vindication. But they’re wrong again. The bad news is real. But so are reform’s accomplishments, which won’t go away even if nothing is done to fix the problems now appearing. And technically, if not politically, those problems are quite easy to fix. Health reform had two big goals: to cover the uninsured and to rein in the overall growth of health care costs — to “bend the curve,” in the jargon of health policy wonks. Sure enough, the fraction of Americans without health insurance has declined to its lowest level in history, while health cost growth has plunged: Since Obamacare passed Congress, private insurance costs have risen less than half as fast as they did in the previous decade, and Medicare costs have risen less than a fifth as fast. But if health costs are looking good, what’s with the spike in premiums? It only applies [...]

President Floats Obamacare Fixes and Offers to Let GOP Rename It

NBC NEWS by JON SCHUPPE-OCT 20 2016, 5:10 PM ET President Obama on Thursday proposed a new round of tax credits and a government-run insurance plan for his healthcare reform program, fixes he said would correct jumps in some insurance premiums and the lackluster recruitment of young, healthy people. Obama delivered his message in Florida, singling out Gov. Rick Scott for his refusal to participate in Obamacare's offer to expand Medicaid coverage for poor people. If he and the governors of 18 other states took part, four million more people would be able to afford insurance, Obama said. Those corrections, he told an audience at Miami Dade College, would bring Obamacare much closer to reducing the number of uninsured Americans — a figure that currently stands at about 29 million people. He said he welcomed additional ideas from his Republican opponents in Congress, even if they wanted to rechristen it. "They can even change the name of the law to Reagancare," Obama said, drawing laughs from the crowd. "Or they can call it Paul Ryancare," Obama added, referring to the speaker of the U.S. House of Representatives. "I don't care — about credit. I just want it to work." As a prelude to his proposed solutions, Obama spent half of his 40-minute speech touting the Affordable Care Act, which many Republicans, including presidential candidate Donald Trump, have vowed to repeal. He pointed out that about 20 million more Americans have signed up for insurance since the program began offering state-based marketplaces and expanded Medicaid four years ago, bringing the uninsured rate to its lowest number in decades. But there have been many well publicized stumbles, including broken websites and dramatic increases in premiums, not to [...]

Obamacare Enrollment to See ‘Significant Slowdown’ Next Year

by Katherine Doherty Bloomberg News October 13, 2016 — 7:05 AM PDT Updated on October 13, 2016 — 8:55 AM PDT Enrollment in the Obamacare insurance marketplace is likely to stall or even decline for 2017 as higher premiums drive away people who aren’t eligible for government subsidies, according to S&P Global Ratings forecasts. “Our forecasted modest-to-negative growth is clearly a bump in the road, but doesn’t signal ‘game-over’ for the marketplace,” S&P analyst Deep Banerjee wrote in a report released Thursday. This November will be the fourth open enrollment period for individuals to choose insurance plans under the Affordable Care Act, President Barack Obama’s signature health-care law. The “significant slowdown” predicted by S&P would be another setback for ACA’s government-run insurance markets, after big insurers pulled out of many states because of mounting losses. ACA enrollment will range from 10.2 million to 11.6 million people after 2017’s enrollment season, which starts Nov. 1, S&P said. The lower end of the forecast range implies a decline of 8 percent compared with 2016 and the higher end a 4 percent gain. With premiums set to rise an average of 25 percent across the marketplace, according to data from ACASignups.net, some current enrollees who aren’t eligible for tax credits may not re-enroll in 2017. Still, a moderation in premium increases beyond 2017 will likely bring growth back to the marketplace, according to S&P. “2017 will not be the year that expansion happens, however a flat year-over-year, or a slight decline should not be mistaken as game over,” analyst Banerjee said in an interview. Banerjee described next year as one step back and one step forward for the ACA. He expects lapses among people who don’t get subsidies, [...]

ObamaCare’s Meltdown Has Arrived

The Wall Street Journal-  By ANDREW OGLES and LUKE HILGEMANN Updated Oct. 6, 2016 12:50 p.m. ET With insurers pulling back, half of Tennesseans covered under the plan are losing their coverage. Tennessee is ground zero for ObamaCare’s nationwide implosion. Late last month the state insurance commissioner, Julie Mix McPeak, approved premium increases of up to 62% in a bid to save the exchange set up under the Affordable Care Act. “I would characterize the exchange market in Tennessee as very near collapse,” she said. Then last week BlueCross BlueShield of Tennessee announced it would leave three of the state’s largest exchange markets—Nashville, Memphis and Knoxville. “We have experienced losses approaching $500 million over the course of three years on ACA plans,” the company said, “which is unsustainable.” As a result, more than 100,000 Tennesseans will be forced to seek out new coverage for 2017. BlueCross is only the latest insurer to head for the exits. Community Health Alliance, the insurance co-op established under ObamaCare, is winding down due to financial failure, leaving 30,000 people without coverage. UnitedHealthcare said in April it is departing Tennessee’s exchange after significant losses. That’s another 41,000 people needing new plans. All told, more than 60% of our state’s ObamaCare consumers will lose their coverage heading into 2017. When they go in search of a replacement plan, they will confront two unfortunate realities: a dearth of options and skyrocketing costs. Seventy-three out of Tennessee’s 95 counties will have only one insurer on the exchange, meaning no meaningful competition whatsoever. In regions where BlueCross BlueShield is pulling out, there will be two remaining major carriers, Cigna and Humana. The only large metro area with more options will be Chattanooga. Then there [...]