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Leslie Murphy specializes in representing healthcare entities in managed care and healthcare-related disputes. A partner in our Life Sciences and Healthcare practice, Leslie regularly serves as lead counsel on behalf of hospital systems and healthcare providers in managed care disputes with health plans, and counsels clients on complex medical billing, coding and reimbursement matters.

Leslie represents hospital systems and healthcare providers in managed care and healthcare-related business disputes. She has served as lead counsel in arbitrations involving a broad range of disputes, including matters involving managed care contracting; capitation and fee-for-service reimbursement; coding issues; medical necessity determinations; payment methodology calculations; and exclusivity provisions.

Leslie has substantial experience in developing cost-effective case management processes for complex medical billing, coding and contract disputes that involve voluminous records. She regularly manages disputes involving thousands of provider claims using customized databases for efficient discovery and hearing preparation. She is highly knowledgeable in health information documentation, data integrity and quality, as well as in coding and billing. Leslie is a Certified Coding Specialist, Physician Based (CCS–P), a certification of in-depth knowledge of the CPT coding system and familiarity with the ICD–10–CM and HCPCS Level II coding systems.

Leslie also advises hospital systems and healthcare provider clients regarding a variety of operational and compliance matters. She understands relevant regulation and compliance processes, allowing her to help healthcare clients understand and address legal obligations and promote organizational integrity through effective compliance programs. Leslie has experience in conducting internal compliance investigations and in establishing, enhancing and evaluating compliance programs.

Leslie also advises clients on Health Insurance Portability and Accountability Act, or HIPAA, and state privacy compliance matters, including drafting and revising Privacy and Security policies, along with employee training. Leslie is certified in Healthcare Compliance.

Full Bio

Matters

Represented a medical group in binding arbitration regarding exclusivity provisions in a professional services agreement.

Represented a large healthcare system in binding arbitration regarding the interpretation of various contract provisions and the applicability of the Medicare OPPS payment caps on radiology services.

Represented a large healthcare system in binding arbitration with a managed care company regarding the interpretation of various contract provisions related to reimbursement of laboratory, injectables, maternity, NICU, acute rehabilitation and other claim types.

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Matters

Represented a medical group in binding arbitration regarding exclusivity provisions in a professional services agreement.

Represented a large healthcare system in binding arbitration regarding the interpretation of various contract provisions and the applicability of the Medicare OPPS payment caps on radiology services.

Represented a large healthcare system in binding arbitration with a managed care company regarding the interpretation of various contract provisions related to reimbursement of laboratory, injectables, maternity, NICU, acute rehabilitation and other claim types.

Represented a hospital in binding arbitration with a managed care company regarding pre-transplant and transplant care provided by an out-of-network provider.

Represented a large healthcare system in binding arbitration regarding a managed care company's application of internal guidelines for services deemed "experimental and investigational."

Represented a large healthcare system in binding arbitration with a managed care company regarding level-of-care downgrades.

Represented a large healthcare system in binding arbitration with a managed care company involving bariatric surgery charges.

Represented a large healthcare system in binding arbitration with a large health plan involving neonatal intensive care unit charges and coding and other medical necessity denials.

Matters

Represented a medical group in binding arbitration regarding exclusivity provisions in a professional services agreement.

Represented a large healthcare system in binding arbitration regarding the interpretation of various contract provisions and the applicability of the Medicare OPPS payment caps on radiology services.

Represented a large healthcare system in binding arbitration with a managed care company regarding the interpretation of various contract provisions related to reimbursement of laboratory, injectables, maternity, NICU, acute rehabilitation and other claim types.

See more
Icon close

Close

Matters

Represented a medical group in binding arbitration regarding exclusivity provisions in a professional services agreement.

Represented a large healthcare system in binding arbitration regarding the interpretation of various contract provisions and the applicability of the Medicare OPPS payment caps on radiology services.

Represented a large healthcare system in binding arbitration with a managed care company regarding the interpretation of various contract provisions related to reimbursement of laboratory, injectables, maternity, NICU, acute rehabilitation and other claim types.

Represented a hospital in binding arbitration with a managed care company regarding pre-transplant and transplant care provided by an out-of-network provider.

Represented a large healthcare system in binding arbitration regarding a managed care company's application of internal guidelines for services deemed "experimental and investigational."

Represented a large healthcare system in binding arbitration with a managed care company regarding level-of-care downgrades.

Represented a large healthcare system in binding arbitration with a managed care company involving bariatric surgery charges.

Represented a large healthcare system in binding arbitration with a large health plan involving neonatal intensive care unit charges and coding and other medical necessity denials.

Credentials

California