Eliot Dear, Counsel — Physician Reimbursement Advocate

An emergency physician treats whoever comes through the door and never gets to ask which health plan the patient carries. The patient arrives, the care is given, and only afterward does an insurer decide what that care was worth. Eliot Dear builds his advocacy for emergency physicians around that one fact: the doctor had no say in the network, so the doctor deserves a say in the price.

Care First, Coverage Later

In most of medicine, a practice can check a patient’s plan before an appointment and decide whether to take it. The emergency department does not work that way. The physician on shift treats first, and the paperwork arrives later in the form of an EOB. When that EOB pays an out-of-network emergency physician less than the billed charges, the physician is left holding a number set by someone who was never in the room.

What Advocacy Means in the ER

For an emergency physician, advocacy is not a phone call to a claims line. It is a formal submission in Independent Dispute Resolution, built from the EOB, the physician’s documentation of the care and the billed charges, then reviewed and signed by Eliot Dear under his New York bar registration, #4329546. When the patient’s coverage is a fully insured New York plan, the dispute belongs in New York State IDR, administered by the Department of Financial Services. A self-funded plan sits outside the state process, so sorting the plan is the first step at intake.

A Benchmark the Insurer Did Not Choose

New York law names the FAIR Health 80th percentile as the benchmark. That gives an emergency physician a reference point that does not depend on what the insurer decided to pay. Each submission Eliot Dear signs puts the billed charges, the EOB and the documentation of the visit side by side. A determination carries a 30-day payment deadline, and once it issues, the payment demand goes out.

Built for Doctors Who Work Shifts

Emergency physicians spend their hours on patients, not on paperwork, and the terms are set up for that: a 10% contingency on the improvement, no upfront fee, no contracts and no onboarding. Claims Assassins does not take over the group’s billing. The physician or the billing office sends a claim and its EOB; Eliot Dear tracks the deadlines and handles the filing from there.

One ER Claim to Start

An emergency group unsure whether its out-of-network claims are worth disputing can send Eliot Dear a single claim for a free review. The reply comes from counsel, not a call center.