Elloit Dear, Esquire — Out-of-Network Reimbursement Lawyer

Three specialties send their out-of-network claims here: plastic and reconstructive surgery, emergency medicine, and oral and maxillofacial surgery. Each reaches an underpaid claim by its own road, and each hands Elloit Dear, Esquire, a different kind of record to build a submission from.

Plastic and Reconstructive Surgery

Reconstructive work is documented in depth. The operative note lays out the defect, the tissue involved, the technique chosen and the reasons behind it. Where a reconstruction is staged, each stage has its own note, and each one is read. That detail is the core of the submission, because a plan’s allowed amount compresses an intricate reconstruction into a code and a figure. Elloit Dear sets the operative note beside the billed charges so the dispute shows the surgery the code by itself leaves out.

Emergency Medicine

An emergency physician’s chart is written as the visit unfolds: the presenting complaint, the workup, the calls made as the patient’s condition changed. An emergency visit is not planned in advance, so there is no pre-authorization trail behind it, and the chart does the talking. That record carries the acuity of the encounter, and the submission leans on it. Elloit Dear reads the chart and the EOB together, so the dispute reflects the visit the physician actually managed rather than the line the plan reduced.

Oral and Maxillofacial Surgery

Oral and maxillofacial surgeons operate on the face, the jaw and the mouth, where function and appearance are both at stake. Some of that work is planned and some arrives as trauma, and the note makes clear which. The operative notes describe fractures, fixation and anatomy that a reviewer outside the specialty may not picture easily. Elloit Dear makes sure the submission explains the procedure in plain terms next to the billed charges, so the record speaks for itself to whoever decides the dispute.

What the Three Share

Whatever the specialty, the file opens the same way: one claim and its EOB. Elloit Dear places the plan before anything is drafted, because a fully insured New York plan and a self-funded plan take different roads. The allowed amount is then weighed against the FAIR Health 80th percentile, and every submission goes out under Elloit Dear’s own signature and bar number.

Send One Claim

A surgeon or emergency physician in any of the three specialties can send a single claim for a free review, with no upfront fee and no contract.