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PAYER RELATIONS
Ombudsman
The Division of Socio-Medical Economics (SME) offers our MSSNY members help with everyday claim problems on behalf of your patients through our Ombudsman Program. Our division is here to help you and your staff with problems relating to insurance reimbursement for care you render to your patients.
We receive thousands of calls each year regarding Medicare, Medicaid, Workers' Comp, No-Fault, managed care, traditional indemnity plans, coding, billing, etc. Sometimes we help our members by explaining insurer requirements. In other cases we may argue with a health plan on behalf of our members for policy clarification or proper payment of a bill or claim. In 2004, our Ombudsman Program recovered $64,764.58 for members. In 2005, our Ombudsman Program recovered $66,651.86 for members.
If you would like to know more about our Ombudsman service, please click on the following link:
HOW THE OMBUDSMAN PROGRAM FUNCTIONS
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