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Jan 10

Written by: Amanda Patanow
1/10/2010 

Dr. Steven Rosenberg is a patient man.

But after waiting more than two years for Humana insurance to reimburse his West Palm Beach dermatology practice for roughly $120,000 worth of unpaid claims, he'd had enough.

"It was like hitting our heads against the wall getting them to acknowledge our claims other than to say they were expediting the process," said Rosenberg, president of the 21-doctor Palm Beach Dermatology and Pathology.

Unwilling to pay an attorney up to 40 percent of the amount that was ultimately collected, Rosenberg decided to put down put down his medical journals and pick up some legal forms.

He took the insurance giant to small claims court, a so-called people's court where warring neighbors, distraught tenants and angry consumers can represent themselves in disputes worth less than $5,000. Since most of the claims were under $200, he bundled a few together to stay under the $5,000 limit.

"Where have you heard of someone suing for $5,000 and getting $80,000?" he said last week about the unique — and ongoing — court fight he initiated in November.

Like many successful fights, the key to Rosenberg's was surprise.

His unconventional move surprised the North Miami Beach attorney Humana hired to represent it.

"He said he had never been to small claims court before," Rosenberg said.

And, Rosenberg added, it was clear the University of Miami educated lawyer didn't want to waste much time there. He offered to settle.

Rosenberg accepted the offer but warned him that his time in small claims court was far from over.

"This is the first of 25 claims we'll be submitting," he said. "I told him Humana could save those $350 filing fees times 25 and his time and fees times 25 if they would just process our claims."

The attorney seemed to accept the logic and promised he would see what he could do.

Two days later, Rosenberg got a check for the first claim. Then, nothing.

So, Rosenberg filed a second lawsuit in small claims court.

Suddenly checks started arriving. In the last month, he estimates he received about $80,000 in reimbursement from Humana and is hopeful the other $40,000 will arrive before the second case goes to court in mid-January.

North Miami attorney George Wickhorst, who represents Humana, declined comment. Mitch Lubitz, a spokesman for Humana, offered this terse response: "We are working to resolve the matter with Dr. Rosenberg."

Doctors, who are all too familiar with Rosenberg's financial dilemma, cheered his approach.

"It's creative," said Dr. Mark Rubenstein, a pain and rehabilitation specialist. "It's frustrating as a physician when you're faced with denial of reimbursement when you believe you're doing the right thing for your patients."

Even lawyers were impressed with Rosenberg's tactics.

"It's not a bad strategy. It's a good way to get their attention," said attorney Richard Benrubi, who often represents people in disputes with insurance companies.

While taking an insurer to small claims court is unusual, he said a chiropractor he represented tried it several years ago. Unfortunately, the insurer successfully petitioned to move her small claims cases to federal court and then buried her in paper. She showed up in his office, asking him to sort it out.

Rosenberg said Wickhorst and Humana have tried to legally out maneuver him. So far, he said, it hasn't worked.

While happy that he won his case and that the reimbursements have started tricking in, he said he wants to be a doctor, not a lawyer.

"It's unfortunate that a doctor would have to waste his time taking insurance companies to small claims court," he said.

 

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