MEDICAL MANAGEMENT ASSOCIATES
FAQ
A little more about us and what we do.
WHAT DOES MMA DO?
MMA handles the PIP arbitration process for our clients from start to finish. We review hundreds of carrier payments per month for our clients in order to identify instances of improper or underpayment. We handle the post-service appeal process for many of our clients, and are able to successfully resolve many denied or underpaid claims on appeal within 45 days from referral.
MMA is proud to be partnered with two of New Jersey's preeminent PIP Law firms, Midlige & Richter and Pinczewski & Baurkot. Any cases that are not able to be resolved through the appeals process are arbitrated by these firms with over a 90% success rate.
In addition to arbitration, we pride ourselves on being a direct and receptive source of knowledge for our clients. We're always happy to take a look at a surgical appeal narrative, get involved with a difficult adjuster, or weigh in on a confusing coverage situation.
WHAT TYPES OF PROVIDERS DOES MMA WORK WITH?
Our clients include multi-campus hospital groups, surgeons, orthopedic and pain management practices, surgery centers, anesthesiologists, chiropractors and physical therapists, and more. Whether your practice employs dozens of providers or just one, we employ a no-client-is-too-big-or-small mentality and can tailor our services to best suit your practice's needs.
WHAT TYPES OF CASES DOES MMA PURSUE?
MMA can pursue claims submitted to an auto insurance carrier that have been denied, unpaid, or underpaid. We commonly prevail on matters relating to medical necessity, causation, improperly imposed penalties or payment reductions, and claims that are unpaid due to coverage disputes. We are also able to pursue proposed/future treatment that has been denied in pre-service, and have succeeded in the authorization of thousands of proposed surgeries, therapeutic injetions, and diagnostic testing through arbitration.
HOW DOES THE PROCESS WORK?
MMA will always strive to work within your system - never the other way around. Whether that means becoming a part of your billing and receivables process (we're familiar with EPIC, eClinical Works, and most other commonly used medical billing systems), receiving new case referrals via email, or coming to your practice in person to review printed claims, we always work with our clients to put together a process that works for everyone.
WHAT TYPE OF RESULTS CAN MY PRACTICE EXPECT?
Since 2004, MMA have pursued tens of thousands of cases for our clients with an over 95% success rate.
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Nearly sixty percent of all referred cases are resolved in settlement without the need for arbitration, typically within 45 days or fewer.
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Of cases that do go to arbitration, over 90% are favorably awarded. Cases typically remain in arbitration anywhere from 3 to 12 months, with the average arbitration resolving within 6 months.
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Our aggressive approach to filing proposed surgery cases means that we can typically have a denied surgery authorized by an auto carrier within 3 to 6 months on average, ensuring patients do not have to wait longer than necessary for treatment.
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We are able to identify and pursue instances of improper or underpayment that may otherwise go unnoticed or adjusted off.
Let's see what we can recover for you.