Schneider-Zenna
& Gaffney
Attorneys At Law
Exclusively Representing Medical Providers & Facilities
175 Washington Street, Morristown NJ 07960
973-401-9400 (phone)
973-401-9401 (fax)
legal@szglaw.com (email)
about
Schneider-Zenna & Gaffney is a boutique law firm specializing in healthcare reimbursement disputes with insurance companies and self-funded Plans. Our practice covers commercial insurance disputes, workers compensation, and PIP from Appeal/Rejection to conclusion. We navigate the evolving No Surprise Act, representing out-of-network providers in Federal and New Jersey State cases. With personalized attention, our goal is to maximize reimbursement efficiently.
experience
Stephanie Schneider-Zenna, Esq. and Kellylyn Gaffney, Esq. bring over 30 years of collective experience in insurance law, having served as in-house counsel for major commercial carriers. Over the past 16 years, our practice has focused exclusively on navigating insurance disputes to secure maximum reimbursement for our clients. We are not only seasoned litigators, but we also possess expertise in medical billing and coding, appeals, negotiations, out-of-network billing regulations, and the New Jersey State and Federal Arbitration Process.
client focus
We pride ourselves on providing personalized attention. We do not work on high volume and there is no staff or associate turnover in our firm which can lead to oversight, miscommunication and unnecessary delay. With direct communication between our team and yours, we streamline the handling of your cases efficiently. Our expertise extends beyond the New Jersey PIP Fee Schedule, encompassing a comprehensive understanding of billing intricacies such as RVUs, CCI Edits, modifiers, and add-on codes. Additionally, we have extensive experience with UCR, FairHealth, and Optum 360 databases. Over our years of practice, we've cultivated strong working relationships with representatives at various carriers, TPAs, State Maximus Representatives, and various IDRE representatives in the Federal NSA Dispute Process.
results
Since the Federal No Surprise Act's inception, our firm has achieved an 81% favorable Final Determination rate for clients, surpassing the national average by 10% according to CMS statistics. Schneider-Zenna & Gaffney offers substantial value to your business, enhancing reimbursement levels effectively.
last 6 months
- June 2023: Elective Spinal surgery initial payment $29,057. Final total reimbursement $170,400
- August 2023: Scheduled Shoulder surgery: Initial payment $2,883.35. Final total reimbursement $45,257.50
- September 2023: Elective Spinal Surgery initial payment $4,553. Final total Reimbursement $99,250
- October 2023: Emergency Spinal Surgery-Federal No Surprise Arbitration. Initial payment $7,820 Final total reimbursement $122,820
- November 2023: Elective Spinal Surgery initial payment $3,657. Final Total Reimbursement $108,657
- November 2023: Scheduled Knee surgery: Initial payment $1,144.14. Final total reimbursement $21,292.50
- January 2024: PIP arbitration settlement prior to hearing: 1st two dates of service trauma (UCR), 3rd date of service (improper PIP Fee Schedule application); Health insurance primary with initial payment $4,719.35. Final total reimbursement by PIP carrier $48,936.00
- February 2024: Scheduled shoulder surgery: Initial payment $2,600.17, Final total reimbursement $40,125.00
