Government Regulatory Coverage
No healthcare provider or medical practice is immune to risks associated with billing, government regulatory compliance, and/or patient privacy. Professional Risk can review the current coverage enhancements included in
One Quick Review, Thousands Saved
your medical malpractice insurance policy and compare them to the unique exposures your practice faces.
Just a few minutes of reviewing your coverage options could save you money and keep your practice afloat in the event of a billing audit, HIPAA, or other regulatory violations. Professional Risk offers solutions to cover legal expenses, fines, and penalties from billing errors, HIPAA, Stark Law, and EMTALA proceedings instituted against the insured by a Government Agency, Commercial Payer, or Qui Tam Plaintiffs. This product overview is for description purposes only and does not provide a complete summary of coverage.
Coverage Components
Defense reimbursement for actual or alleged billing errors -
Broad definition includes Government Agencies, Qui Tam Plaintiffs, Recovery Audit Contractors (RAC), Zone Program Integrity Contractors (ZPIC), and Commercial Payers
Defense for other medical regulatory violations -
Coverage includes HIPAA (patient privacy and security), EMTALA (Emergency Medical Treatment and Active Labor Act), Stark Law (physician self-referral) violations
Shadow Audit Professional Fees -
Coverage for fees of a pre-approved shadow audit to be performed on your behalf in the event of a claim arising out of a billing errors proceeding
Unintentional Billing Errors & Omissions -
Coverage for unintentional acts made by providers or outside billing organizations
Waiver of co-insurance upon selection of panel counsel -
Available in all states
Eligibility -
Organizations delivering direct medical or medically-related services. Classes include, but are not limited to, the following:
> Allied Health Facilities
> Mental Health Facilities
> Billing Entities
> Physician Groups
> Hospitals
> Solo Physicians
Medefense Plus
Healthcare Billing Risks
OUR TRUSTED CARRIERS
All of our Professional Liability Carriers are rated "Excellent" or higher by A.M. Best.