Insurance Audits

The practice of medicine inevitably involves the use of billing codes and required documentation. As a result, the independent audit by government agencies or private insurers has become a fact of life. Inevitably, these audits are conducted by individuals not fully versed in the practice of medicine who inevitably seek to disallow various charges based upon rigid criteria. The stress of the practice of medicine can be greatly increased when the practitioner receives the dreaded request for a refund. We have undertaken several successful responses to such audits resulting in a significant reduction in the amount owed. In preparing the attorney's response to the audit or appeal, emphasis is placed on minimizing attorneys' fees to make the presentation cost effective. We also stress identifying and categorizing the objections to various services. In this way, the audit letter, which appears to be an overwhelming list of objections, is simplified. Our ultimate goal is to afford the client a reduction in the claimed refund exceeding the cost of legal fees in responding to the audit.

Awards & Associations

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Disclaimer

The information contained on this website is for informational purposes only and is not, nor is it intended to be, a source of solicitation or legal advice. Use of this website does not create, nor does it establish, an attorney/client relationship. Individuals should not rely on the information contained in this website when making decisions regarding legal matters, and should consult with a qualified attorney for legal advice.

Copyright © 2017 Thuillez, Ford, Gold, Butler & Monroe, LLP

Prior results cannot and do not guarantee or predict a similar outcome with respect to any future matter, including yours, in which a lawyer or law firm may be retained.

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