Insurance Recovery Advocate (IRA) partners with hospitals and other healthcare providers to help maximize reimbursement from group health insurance plans such as Aetna, Blue Cross Blue Shield, Cigna, UnitedHealthcare, ERISA plans, and others.
Hospitals face ongoing challenges in securing proper reimbursement from commercial insurers and payers. Many of these insurers frequently delay or deny payment of valid claims that should have been processed and paid long ago. This creates frustration not only for providers but also for patients who pay substantial premiums expecting their healthcare costs to be covered.
After delivering necessary medical care, hospitals and providers submit claims with the reasonable expectation of timely and accurate payment under plan provisions and managed care agreements. Unfortunately, that expectation is often unmet.
IRA actively challenges all forms of delay, denial, or improper payment of insurance claims. Our mission is to maximize commercial healthcare reimbursement and revenue—ensuring claims are paid in full and recovering any penalties or interest owed due to delayed or denied payments.
Insurance Recovery Advocates (IRA) partners with hospitals to assist in recovering payments from insurance carriers. When patients are injured in accidents that lead to personal injury or tort claims—often involving negligent parties and their auto insurers, such as Allstate, Farmers, State Farm, or USAA—the hospital’s right to payment may become linked to those legal claims.
After receiving treatment, patients frequently hire personal injury attorneys to pursue recovery of first-party benefits, including Personal Injury Protection (PIP) or MedPay, Uninsured Motorist (UM), and Underinsured Motorist (UIM) coverage, as well as third-party liability benefits under the at-fault driver’s policy. Hospitals have strong legal protections to ensure proper reimbursement for medical services provided to accident victims, whether the injuries stem from automobile accidents, slip-and-fall incidents, dog bites, ATV crashes, or similar events.
IRA also works directly with patients to help them navigate the claims process and secure appropriate payment from the responsible insurer—reducing the risk of personal financial burden. Patients deserve access to quality care that supports both their physical recovery and financial security.
Insurance Recovery Advocates is committed to ensuring timely and proper payment pursuant to the applicable state fee schedules. Recognizing that unforeseen obstacles often impede rightful reimbursement, IRA is fully prepared to address and overcome these challenges.
Healthcare plans and payers sometimes seek refunds of claims that were previously paid, often months or even years after the original payment. Insurance Recovery Advocates vigorously challenges these refund demands to protect our clients’ rights.