$53K MAP Lien Wiped Out Through Appeal and Statutory Argument

Upon receipt of a more than $53,000 Demand from a MAP, our client reached out for assistance to contest the legitimacy of the charges outlined in the payment summary form. The client had previously paid to resolve a $5,000 lien with this MAP, and this apparently emboldened the MAP to Demand the additional roughly $53,000 because the MAP argued the prior $5,000 lien payment “proved” the carrier’s “acceptance of responsibility” for additional care that included the same diagnosis codes with the same providers.

Our experts here at Sanderson Firm dug in and reviewed the entire claim file, and determined the treatment at issue was inconsistent with the jurisdiction’s Utilization Review process. We successfully appealed the entire $53,000+ lien while ensuring the MAP followed the recovery process appropriately and accepted determinative MSP statutory arguments.