NodalHealthGuard regulatory risk coverage, part of our medical malpractice insurance policy, provides members with legal representation for administrative actions brought by Medicare/Medicaid, medical licensing boards, credentialing reviews and actions, Professional Review Organizations, government agencies in healthcare.

Coverage Features

Utilization
Addresses Medicare and Medicaid utilization and billing review proceedings, including allegations of improper documentation involving overutilization, overbilling, unnecessary services charges, and “up coding.”

Licensing
Covers state medical licensing board reviews involving potential sanctions for unprofessional conduct.

Credentialing
Covers healthcare provider credentialing reviews that may adversely affect existing clinical privileges, credentialing, or staff membership.

Misconduct
Provides protection for Professional Review Organization proceedings involving allegations of misconduct.