100
Have denied claims?
100
Payment suspension?
100
Received an audit?
100
Help with compliance?
What to Expect
Support for in-network and out-of-network providers. Payors of all kinds have an obligation to monitor the community for fraud & abuse. Once you receive notice of a payor audit you have an opportunity to review compliance, negotiate any errors and avoid sanctions.
Your team will work alongside ours, from your billing & coding staff to in-house counsel in some cases to do a risk evaluation and analyze your exposure for the audit period.
We take the time to do a full diagnostic and prepare for follow-up activity before we respond. The goal is to prevent soft flags and keep your business flowing throughout the audit process. We believe that open lines of communication are essential for all sides to work through an audit quickly and efficiently.
Medicare/Medicaid Audit
Commercial Plan Audit
Care & Quality Improvement Audit
ZPIC Audit
Payment Suspension Rebuttal
RAC Audit
Medicare Appeal
DEA Audit
Our experienced attorneys routinely assist clients in identifying areas for improvement
We analyze risk in billing practices
We identify documentation and systems that validate a claim
We challenge overpayment demands and allegations of fraudulent billing
We provide representation on denied claims, false claims or overutilization of services.