Unique or Challenging Insurance Coverage Scenarios

Traditional insurance companies use past claims information as indicators for future claim projections. This can cause difficulty when a physician, dentist, clinic, or healthcare provider is “blazing a trail” with new procedures or a new method for delivering care. Presidio staff has vast experience helping innovative physicians, dentists and healthcare providers obtain the coverage they need to practice with peace of mind. We guide the client in obtaining and documenting information (insurance companies are wary of the unknown!). We offer suggestions and solutions to present you to insurance companies in the best possible light. And, we know from experience where to find coverage for unique or unusual coverage situations. Here are some examples of clients we have assisted.

  1. Family physician expanded services to include delivery of services to “executive patients” in a home or office setting
  2. OB/GYN providing “hormone” related consultation
  3. Healthcare providers at community and sporting events
  4. Mobile healthcare services
  5. Multi-state telemedicine group

Claims or medical board challenges

Claims issues and licensing board investigations can be hurdles in obtaining comprehensive and competitive coverage. We clear the hurdles by looking at creative solutions for coverage and laying out a plan for the future. We look at the problem to discover what caused it, how it can be prevented in the future, and what solutions we use now to get through the “transition” period. This means looking at deductible options, coverage exclusions, perhaps even considering whether certain procedures should be referred out. We work hard to come up with a plan that works now while also heading in the right direction for the future. We have had enormous success representing clients in difficult situations. We bring understanding, experience, and the desire to act with YOUR best interest at heart.

Alternative, aesthetics and/or cosmetics practice

Alternative, aesthetics and/or cosmetic procedures can often be included within a traditional policy depending on percentage of the practice it involves, primary practice profile and additional training obtained. However, when the practice becomes heavily weighted in aesthetics, alternative, or cosmetics, we generally turn to non-traditional companies for coverage. Often these insurance companies are better suited to accommodate risks involving alternative medicine, aesthetics, or cosmetics. However, coverage is generally more restrictive amongst the non-traditional carriers so care must be taken to consider coverage exclusions or limitations.