In this episode of From the Clinic to the Courtroom: Health Law Unpacked, Maria T. Santi, Esq. discusses what makes health insurance denial cases so complex—and why choosing the right attorney is critical to success. Drawing from her personal journey from aspiring pediatrician to health law attorney, Maria shares what motivated her to build a practice dedicated to helping patients gain access to vital care. She outlines red flags to look out for when hiring legal help, emphasizes the value of compassion in health law, and offers practical tips for patients who may be navigating a denial. This is a must-listen for anyone facing a medical insurance dispute or looking to better understand this highly specialized legal niche.

• 00:01 – Welcome to From the Clinic to the Courtroom
• 00:35 – Why health law is different from other legal areas
• 01:46 – Navigating federal, state, and administrative law in denial cases
• 02:24 – Maria's personal story: from medicine to psychology to law
• 05:19 – Finding purpose through helping others access medical care
• 06:07 – How a psychology background helps with insurance appeals
• 07:48 – What to ask when interviewing an attorney
• 08:59 – Red flags when choosing legal representation
• 10:33 – Why empathy and compassion are essential in health law
• 12:02 – The role of medical debt in financial hardship and bankruptcy
• 13:01 – The importance of understanding insurance coverage guidelines
• 14:12 – Why many patients feel defeated before seeking legal help
• 15:05 – Closing thoughts and how to connect with Maria’s team

From the Clinic to the Courtroom: Health Law Unpacked offers practical legal insights for patients, healthcare providers, and professionals navigating the complexities of health law. Hosted by Kevin Rosenquist and featuring Maria T. Santi, Esq., each episode breaks down essential topics—from insurance denials to legal rights—with clarity and compassion.

In this episode of From the Clinic to the Courtroom: Health Law Unpacked, host Kevin Rosenquist is joined by Maria T. Santi, Esq., founder and managing partner of the Health and Medicine Law Firm, to tackle a question many people face but few know how to answer: Can you really sue your health insurance company?

Maria explains that the answer is yes — and she walks us through the legal process, from exhausting appeals to filing emergency injunctions for life-saving treatments. Learn when it’s time to take legal action, what the lawsuit process looks like, how long it can take, and why insurance companies often choose to fight even the smallest claims.

Whether you're dealing with a denied claim for cancer treatment, a costly prescription, or outright bad faith by your insurer, this episode delivers practical insight and powerful real-world examples of patient advocacy in action.

00:00 – Introduction Welcome to From the Clinic to the Courtroom and an overview of today’s topic: suing your health insurer.

00:47 – When Can You Sue Your Health Insurance Company? Understanding the appeals process and when legal action becomes necessary.

01:45 – What Happens After You Decide to Sue Reviewing policies, building a case, and filing a complaint.

04:05 – Emergency Cases & Injunctions How terminal patients can seek urgent court intervention to access denied treatment.

05:27 – Bad Faith & Misconduct by Insurers What qualifies as bad faith in Florida and how it impacts damages.

07:04 – How Lawsuits Differ Based on the Type of Plan ERISA, ACA protections, and Medicaid/Medicare administrative hurdles.

08:53 – How Long Does a Lawsuit Take? The timeline: from a few months to several years depending on insurer resistance.

11:39 – Do Most Cases Settle? Why 90% of lawsuits eventually settle — and why some insurers still drag things out.

13:23 – Legal Delay Tactics How insurance companies prolong litigation and overwhelm courts.

14:49 – Do People Even Know They Can Sue? Why most people don’t realize health insurance can be challenged legally.

15:46 – The Psychology of Trusting Insurers Exploring why patients often accept insurance decisions without question.

17:04 – Closing Thoughts How to connect with Maria and why you shouldn’t give up when fighting for your health.

From the Clinic to the Courtroom: Health Law Unpacked is your go-to resource for understanding the intersection of healthcare and the law. Hosted by Maria T. Santi, Esq., and produced by the Health and Medicine Law Firm, each episode breaks down legal issues affecting patients, providers, and policyholders — making complex topics accessible and empowering you with knowledge and options.

Connect with Maria and her team at: healthandmedicinelawfirm.com

In this episode of From the Clinic to the Courtroom: Health Law Unpacked, host Kevin Rosenquist and health law attorney Maria T. Santi, Esq. walk listeners through the complicated and often overwhelming process of appealing a health insurance denial. Whether it’s a time-sensitive treatment or a misunderstood policy exclusion, Maria shares the critical steps patients must take to protect their rights—from reviewing the denial letter to filing a lawsuit if necessary.

You’ll learn:

• What to do immediately after receiving a denial.
• The difference between internal appeals, external reviews, and lawsuits.
• The most common—and costly—mistakes patients make.
• How to gather documentation that makes a case stronger.
• How to feel empowered when taking on a large insurance company.

If you’ve ever been denied coverage or know someone navigating the appeals process, this episode is a must-listen.

00:00 – Welcome and episode introduction 00:44 – First steps after receiving an insurance denial 02:00 – Gathering documentation and working with doctors and attorneys 03:15 – How to properly structure an appeal package 04:52 – Timelines: When insurance companies must respond 05:19 – Internal vs. external appeals explained 07:22 – When to file a lawsuit 08:49 – Jury trials, costs, and who pays attorney fees 10:19 – Missing deadlines: Are appeals still possible? 11:55 – Common patient mistakes during appeals 13:43 – How Maria empowers clients through the process 15:01 – Episode close and how to connect with Maria's team

From the Clinic to the Courtroom: Health Law Unpacked is hosted by Maria T. Santi, Esq., founder and managing partner of the Health and Medicine Law Firm. Each episode demystifies a crucial aspect of health law, offering patients and providers alike the legal clarity and tools they need to navigate the healthcare system. Whether it's insurance denials, patient rights, or provider compliance, Maria’s mission is to educate and empower.

Learn more at healthandmedicinelawfirm.com

In this episode of From the Clinic to the Courtroom: Health Law Unpacked, host Kevin Rosenquist is joined by Maria T. Santi, Esq., founder and managing partner of the Health and Medicine Law Firm, to unpack the frustrating—and often confusing—reality of mental health treatment denials by insurance companies.

Maria dives into:

• Why these denials happen
• The different levels of mental health care
• How the Mental Health Parity Law impacts coverage
• Steps patients and families can take to fight back
• What documentation is essential in legal appeals
• Why persistence and proper legal support can make all the difference

Whether you're a patient, parent, provider, or policymaker, this conversation sheds critical light on the legal rights surrounding mental health care access.

• 00:01 – Welcome to From the Clinic to the Courtroom
• 00:35 – Why insurance companies often deny mental health treatments
• 01:10 – Levels of mental health care and how insurers determine coverage
• 02:31 – Has access to mental health treatment improved?
• 03:09 – How mental and physical health are treated differently by insurers
• 04:47 – Do insurers have to follow the Mental Health Parity Law?
• 05:42 – What to do if your mental health treatment is denied
• 07:07 – How successful are appeals, and what affects outcomes?
• 08:03 – How providers can help strengthen an appeal
• 08:32 – What needs to change to improve success rates
• 09:20 – What patients and families should keep in a documentation file
• 10:30 – How personal and family history may factor in
• 12:33 – Questions lawyers ask to evaluate a denial case
• 14:08 – The financial incentives behind insurance denials
• 15:22 – Know your rights and don’t give up

From the Clinic to the Courtroom: Health Law Unpacked brings you inside the intersections of healthcare, insurance, and law with Maria T. Santi, Esq., a seasoned health law attorney and founder of the Health and Medicine Law Firm. Each episode provides practical legal insights and real-world strategies for patients, families, and providers navigating complex healthcare challenges.

Episode Summary:

In this informative episode, Maria T. Santi Esquire discusses common insurance denials for pediatric and newborn care. She shares insights on navigating insurance challenges, from newborn coverage complications to fighting denials for specific treatments. The episode covers important topics like autism therapy coverage, growth hormone treatments, and the appeals process for denied claims.

Key Timestamps:

00:01 - Show Introduction

00:44 - Common insurance denials for newborns

02:59 - Coverage issues for children with autism

05:40 - Discussion on denied coverage for ear tube surgery

07:17 - How parents can advocate for their child's care

11:32 - Real case examples of successful legal interventions

14:33 - Advice for parents facing insurance denials

About the Show:

"From the Clinic to the Courtroom: Health Law Unpacked" features Maria T. Santi Esquire, founder and managing partner of the Health and Medicine Law Firm. The show provides valuable insights into healthcare legal matters, hosted by Kevin Rosenquist.

In this episode of From the Clinic to the Courtroom – Health Law Unpacked, host Kevin Rosenquist is joined by attorney Maria T. Santi, founder and managing partner of the Health and Medicine Law Firm. Together, they discuss the troubling reality of emergency room visit denials by insurance companies and what legal steps patients can take when their emergency care isn’t covered.

Maria explains how federal laws like the Emergency Medical Treatment and Labor Act (EMTALA) and the Affordable Care Act (ACA) are supposed to protect patients but don’t always guarantee insurance coverage. She shares real-life cases where insurers have denied life-saving emergency care, the legal recourse available, and the need for legislative reforms to prevent unfair denials.

Tune in to learn how insurance companies justify denials, what patients can do to fight back, and how the law can be improved to ensure fair treatment.

• 00:00 – Welcome to From the Clinic to the Courtroom – Health Law Unpacked
• 00:06 – Introduction to today’s topic: Insurance denials for emergency room visits
• 00:33 – Why emergency denials happen despite EMTALA protections
• 00:52 – Common reasons insurance companies deny emergency room claims
• 01:52 – Case study: A patient denied emergency care after a medically necessary cosmetic procedure
• 03:51 – How hospitals and insurers negotiate coverage behind the scenes
• 05:14 – The insurance denial process: How decisions are made
• 06:14 – Understanding EMTALA and ACA protections for emergency care
• 07:56 – How often emergency room denials are overturned
• 08:55 – The need for legal reforms to protect patients
• 10:50 – The power of the insurance lobby and its impact on legislative change
• 12:37 – How legal action can push insurance companies to cover claims
• 13:36 – The impact of the No Surprises Act on emergency billing disputes
• 14:07 – How Maria stays focused despite the frustration of dealing with systemic insurance issues
• 15:18 – Closing thoughts and where to connect with Maria T. Santi

From the Clinic to the Courtroom – Health Law Unpacked is a podcast dedicated to exploring the legal side of healthcare. Hosted by Kevin Rosenquist and featuring attorney Maria T. Santi, each episode breaks down critical issues affecting patients, doctors, and healthcare institutions. From insurance disputes to regulatory changes, this show helps listeners navigate the complexities of health law with expert insight and real-world cases.

In this episode of From the Clinic to the Courtroom – Health Law Unpacked, host Kevin Rosenquist and attorney Maria T. Santi, founder and managing partner of the Health and Medicine Law Firm, dive into the complex issue of health insurance denials. They discuss why insurance companies reject claims, the legal rights of patients, and the step-by-step process for appealing a denial. Maria provides valuable insights into navigating the appeals process, working with doctors, and when legal action might be necessary. She also sheds light on the role of in claim denials and the challenges of transparency within the insurance industry.

If you've ever faced a denied claim and felt lost, this episode is a must-listen, offering practical steps to fight back and secure the care you need.

00:00 – Introduction – Welcome to From the Clinic to the Courtroom – Health Law Unpacked 00:06 – Meet Maria T. Santi – Background on Maria and her firm’s mission 00:35 – Why Insurance Denials Happen – Common reasons claims are rejected 01:47 – Is It Just About Profits? – The financial motives behind denials 02:21 – Patient Rights & Appeals Process – Steps to challenge a denial 04:39 – Before Hiring an Attorney – What patients can do on their own 05:28 – How Attorneys Fight Back – Maria’s approach to handling denied claims 07:20 – Success Rates in Appeals – How often appeals overturn denials 08:43 – AI in Insurance Decisions – The hidden role of AI in denials 09:40 – Legal Strategies for Patients – Building a strong case against insurers 10:47 – Do These Cases Go to Trial? – The legal pathways for patients 12:35 – Mediation & Arbitration – Alternative ways to resolve disputes 13:25 – Advice for Patients – Resources and first steps if your claim is denied 14:33 – Doctors as Advocates – How physicians can help in the appeals process 16:10 – Final Thoughts & Takeaways – Why persistence is key in insurance battles 16:29 – Closing Remarks – Connect with Maria and the team

From the Clinic to the Courtroom – Health Law Unpacked is a podcast dedicated to unraveling the complexities of health law. Hosted by Kevin Rosenquist, with expert insights from attorney Maria T. Santi, each episode tackles critical legal issues in healthcare, offering practical advice for patients, providers, and industry professionals.

In this episode of From the Clinic to the Courtroom: Health Law Unpacked, host Kevin Rosenquist sits down with attorney Maria T. Santi, founder and managing partner of the Health & Medicine Law Firm. Maria specializes in health insurance coverage denials, patient rights, medical bill negotiations, and legal actions to protect patients.

She shares her journey from aspiring pediatrician to health law attorney, inspired by personal experiences advocating for her family. Maria discusses common reasons for insurance denials, the rights patients often don’t realize they have, and the complex legal landscape of healthcare law. She also highlights a memorable case where she fought to secure life-saving medication for a young child.

Tune in to learn about how to navigate health insurance denials, patient rights, and the evolving legal challenges in healthcare.

[00:00] – Welcome to From the Clinic to the Courtroom: Health Law Unpacked [00:06] – Introduction to Maria T. Santi and her firm’s mission [00:40] – Overview of Maria’s legal practice: Health insurance denials, patient rights, and medical bill disputes [01:20] – Why do insurance companies deny coverage? (Medical necessity, exclusions, experimental treatments) [02:09] – Patients’ rights and the legal actions available after denials [02:29] – Maria’s journey into health law: From pre-med to law school and starting her own firm [05:08] – The role of compassion and advocacy in healthcare law [05:46] – Key patient rights (privacy, informed consent, medical records access) [07:46] – Why is health law so complex? (Federal, state, and administrative regulations) [09:38] – Staying updated with evolving healthcare laws [11:05] – A memorable case: Securing a $2M life-saving treatment for a child [12:23] – Working with healthcare providers, not against them [13:23] – Are insurance denials getting worse? The role of AI-driven claim denials [14:41] – The broken healthcare system and the frustration of insurance battles [15:35] – Closing thoughts and how to connect with Maria

From the Clinic to the Courtroom: Health Law Unpacked is a podcast dedicated to exploring the intersection of healthcare and the law. Hosted by Kevin Rosenquist and featuring legal expert Maria T. Santi, this podcast dives into patients' rights, healthcare litigation, medical insurance disputes, and the evolving legal challenges in the medical field.

Whether you're a patient, caregiver, healthcare provider, or legal professional, this show provides valuable insights on navigating the complex healthcare system and advocating for your rights.