Claims Dispute, Negotiation & Documentation Services
Claims dispute preparation, out-of-network commercial negotiation support, and documentation services for healthcare organizations, medical billing companies, and counsel.
NSA Arbitration Support
Comprehensive evidentiary preparation, open negotiation management, and certified IDR portal filings for emergency and out-of-network healthcare providers.
ERISA vs. State Plan Jurisdiction Analysis
Pre-filing audit distinguishing state surprise billing laws from federal ERISA self-funded plans.
30-Business-Day Open Negotiation Notice Management
Certified dispatch and documentation of CMS standard notices and counter-offers.
Final-Offer Baseball Arbitration Evidentiary Packets
Custom evidence bundles demonstrating median in-network rates, provider acuity, and clinical complexity.
Certified IDR Entity (CIDRE) Submission & Tracking
Management of certified portal filings and entity fee reconciliations.
Auto Accident Claims Support
Specialized support for complex motor vehicle accident medical claims, PIP statutory fee schedules, medical unbundling defense, and administrative arbitration filings.
Pre-Service Decision-Point Appeals
Timely administrative response to medical director necessity denials and IME cut-offs.
Post-Service Explanation of Benefits Reconciliation
Line-by-line audit of CARC/RARC codes, PPO discount invalidations, and fee reductions.
Statutory Fee Schedule Auditing
Verification of allowable units under state PIP regulations (e.g. N.J.A.C. 11:3-4).
Administrative Arbitration Demand Packages
Preparation of comprehensive demand files for dispute resolution organizations (AAA, Forthright).
Workers' Compensation Dispute Support
Administrative dispute support for contested industrial injury medical bills, treatment guideline defenses, and statutory Independent Bill Review (IBR) filings.
Utilization Review (UR) Denial Counter-Submissions
Preparation of clinical rebuttal documentation against adverse medical treatment decisions.
Official Medical Fee Schedule (OMFS) Auditing
Verification of state-mandated conversion factors, surgical cascading, and diagnostic formulas.
Second Bill Review (SBR) Filing Preparation
Strict statutory compliance with 90-day post-remittance appeal deadlines.
Independent Bill Review (IBR) Administrative Petitions
Filing bundles for state board adjudicators (e.g. California DWC, NY WCB).
Patient & Client Intake Documentation
Enforceable administrative intake infrastructure safeguarding provider recovery rights, lien authorizations, and statutory notice compliance before care is rendered.
Irrevocable Assignment of Benefits (AOB) Agreements
Legally robust contracts assigning direct reimbursement and dispute arbitration rights.
NSA Good Faith Estimate (GFE) Protocol Setup
Point-of-care disclosures compliant with 45 CFR § 149.610 for self-pay/uninsured patients.
Medical Records Authorization & Direct Lien Agreements
Third-party liability agreements and HIPAA-compliant disclosure authorizations.
Commercial Carrier & PIP Policy Identification
Front-desk triage protocols to identify coverage hierarchy and claims adjusters.
TPA & Out-of-Network Commercial Negotiations
Evidence-based negotiation support for out-of-network commercial claims administered by TPAs, insurers, networks, and repricing vendors—including claim-specific Data iSight review workflows.
Plan, TPA & Authority Mapping
Identify the funding arrangement, administrator, network or repricer, and the party authorized to evaluate a counteroffer.
Payment Methodology Reconciliation
Compare the remittance, plan language, coding, and disclosed pricing rationale without assuming a benchmark controls the claim.
Evidence-Based Counteroffer Packages
Organize clinical, contractual, geographic, operational, and commercial evidence into a claim-specific negotiating position.
Data iSight Review & Follow-Up
Review available Data iSight explanations, request missing methodology details, and preserve a complete negotiation and appeal record.
Operational Scope & Non-Attorney Disclaimer
Effective: March 2026Millennova Legal is a specialized operational dispute preparation, medical fee schedule auditing, and statutory claims packaging provider. Millennova Legal does not offer formal legal counsel, establish attorney-client relationships, or engage in the unauthorized practice of law. Where formal legal filings or litigation advocacy are warranted, services are delivered in direct coordination with retaining legal counsel.
Request an Operational Case Audit
Speak with an operational case specialist to assess your disputed accounts, statutory deadlines, or intake workflows.