Administrative Defense Coverage
What is Administrative Defense Coverage?
Administrative Defense Coverage (ADC) is insurance for legal expenses incurred defending actions such as:
- Actions by State Licensing Boards
- Hospital peer review actions or attempts to restrict or revoke privileges
- MCO de-certification or contract terminations
- Actions brought by government payers such as Medicare or Medicaid
- Investigations involving billing and coding practices
- Meaningful Use audits
How is PICA's Administrative Defense Coverage special?
At some point in his or her career, a podiatrist will be audited. Did you know, in most instances, the first appeal of an administrative claim will fail? But did you also know you could be able to appeal an administrative claim up to five times? Some medical professional liability insurance may cover only the first appeal. Because we know how devastating an ADC claim can be to a podiatrist's practice, PICA will be there for you for each of the five levels of appeal allowed (subject to the limits of liability).*
When you receive any notice - legal or other - please call
PICA Claims ASAP for a confidential consultation at
(800) 251-5727 and press 4.
*An appeal from a final disposition of an administrative action against the covered insured shall be considered part of an administrative disciplinary proceeding, provided that the covered insured has the right of appeal under any applicable law, statute, or regulation. Coverage is subject to the limits of liability.
ADC does not include legal actions instituted by the podiatric physician, criminal actions or initial applications for licensure, participation in MCO networks or hospital staff privileges.
Terms and Conditions: The descriptions do not include all terms, conditions, and exclusions in the policy. Please refer to the actual policy and endorsements for complete details of coverage. Policy terms may vary based on individual state requirements. Issuance of coverage is subject to underwriting review and approval.