Elliott Dear, J.D. — New York Attorney & Founder of Claims Assassins

A securitization closes on documents, and every one of them has to agree with every other one. From 2004 to 2008, Elliott Dear worked as an associate in structured finance at Clifford Chance LLP, on CLOs, residential mortgage-backed securities and other asset-backed deals. It was heavy documentation work, where a number stated in one agreement has to match the same number everywhere else it appears.

What Deal Work Teaches About a Record

In a deal, a document that contradicts another document is a problem someone has to fix before closing, not after. Reading every page against every other page is the habit Elliott Dear carried from structured finance into physician disputes. An Independent Dispute Resolution submission is a far smaller file than a securitization, but it runs on the same rule: the record has to agree with itself, and every figure in the argument has to trace back to a page in the file.

Three Documents, Read Against Each Other

A physician dispute is built from the EOB, the operative note and the billed charges. The EOB is the insurer’s own statement of what it allowed. The operative note is the physician’s account of what was done. The billed charges are what the practice asked for. Elliott Dear reads the three against each other the way a deal file is read, and the submission is assembled once they line up.

From Deals to Physicians

Elliott Dear has about twenty years of work in out-of-network physician billing, and in 2018 he founded Claims Assassins to bring attorney-signed Independent Dispute Resolution to plastic and reconstructive surgeons, emergency physicians and oral and maxillofacial surgeons. He holds a J.D. from Fordham University School of Law, where he served on the Fordham Law Review, and he is a New York attorney, registration #4329546, admitted to the New York bar in 2005 and in good standing.

Where the Record Goes

For a fully insured New York plan, the record goes into New York State IDR, which the Department of Financial Services administers, and it is measured against the benchmark New York law names, the FAIR Health 80th percentile. A self-funded plan sits outside the state process. Elliott Dear signs each submission under his bar number, and after a determination, which carries a 30-day payment deadline, the payment demand goes out.

Terms

The fee is a 10% contingency on the improvement. There is no upfront fee, no contract and no onboarding, and the office keeps its own billing. A physician can send one claim and its EOB for a free review.