MEDEFENSE® Plus: Essential Coverage for Healthcare Providers

MEDEFENSE® Plus is NAS’ unique insurance solution for healthcare providers. Providing coverage for actual or alleged billing errors, MEDEFENSE® Plus provides broad policy language and free choice of counsel and reimburses defense costs, fines and penalties, and shadow audit expenses incurred in proceedings brought by federal or state government agencies, qui tam plaintiffs, and contractors working on behalf of the government, such as ZPIC and RAC.
Eligible classes include medical groups and healthcare facilities that provide direct patient care services and bill to Medicare, Medicaid, or other public and private payors. 
Risk: Oral Surgeon
Product: MEDEFENSE® Plus
Premium: $1,200
New business account that fit in the our Medical Group Program Packet rate. No claims or loss history, 1 dentist, and necessary protocols in place which made them a fit for the program.
Risk: Nursing Home and Rehabilitation
Product:  MEDEFENSE® Plus with e-MD®
Premium: $10,331
New business account written on NAS Online. To fit online, this risk must have less than $50M in revenue. This account was claims free and fit under the revenue criteria.
The Insured is an owner of urgent care facilities with locations in many states. Two qui tam actions were filed against the Insured alleging fraudulent billing for unnecessary allergy and flu testing. 
The qui tam action alleged that the Insured inflated its billings for urgent care medical services (known as “up-coding”). The Insured was reimbursed over $1 million in legal fees under the insurance.
Kareen is a Southern California native who graduated with a Sociology degree from UC Santa Barbara and joined NAS in 2011 as an underwriting assistant. Currently, Kareen is an Assistant Vice President in the Specialty Underwriting Department and the National Product Leader for MEDEFENSE® Plus and e-MD®.
When Kareen isn’t traveling or hunting for ice cream, she’ll be enjoying her signature Jameson on the rocks at her favorite pool hall.
Did you notice one of our recently written accounts was placed through NAS Online? 

January, 2019