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Medical Billing E&O

Who has Medical Billing E&O exposure?

  • Nursing Homes

  • Assisted Living Facilities

  • Home Health Agencies

  • Doctor's Offices

  • Miscellaneous Medical Companies

  • For-profit & Non-profit Companies

  • Healthcare Practices or Individual Practitioners


Medical Billing E&O Covers:

  • Violation of civil, federal, or state anti-kick back laws

  • Violation of HIPAA and EMTALA legislation

  • Qui Tam/Whistle Blower plaintiff coverage

  • Coverage for both governmental and commercial pay or audits and actions

  • Coverage for 3rd party claims arising out of a Wrongful Act in the performance of, or failure to, perform Medical Billing and Coding Services

  • Coverage for costs and expenses for an independent audit to be undertaken into the billing practices following notification of an actual or alleged wrongful act

  • Cyber elements of coverage available

What is at stake:

  • Fines up to $250,000

  • Additional Civil fines starting at $11,000 per false claim

  • Civil kickback fines of $50,000

Common Coverage Triggers and Program Features include:

  • Medicare/Medicaid billing investigations

  • False Claims Act investigations

  • Qui Tam/Whistleblower suits

  • Stark or Anti-kickback violations

  • HIPPA & EMTALA Proceedings

  • Worldwide coverage

  • Limits from $1m - $10m

  • Deductibles from $5,000 - $25,000

For more information, please visit our Healthcare Professional Liability Division.

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