Defending a Laboratory Network in Fraud Allegations
A laboratory network faced allegations of fraudulent billing practices. We conducted an independent review of their billing processes, identified the source of errors, and provided corrective recommendations. Our expert report played a pivotal role in dismissing the allegations and restoring the network’s reputation.
Audit Defense for a Behavioral Health Facility
A behavioral health facility undergoing an OIG audit turned to us for assistance. Our team reviewed the audit findings, identified errors in the auditor’s calculations, and prepared a detailed rebuttal. This proactive approach resulted in a reduction of penalties and reinforced the facility’s compliance practices.
Assisting a Physician Group in RVU Compensation Disputes
A physician group faced allegations of misaligned RVU-based compensation models. We analyzed their compensation structures, verified the integrity of RVU calculations, and provided documentation to support their compliance. This evidence helped the group resolve the dispute favorably without penalties.
Resolving a Payer Dispute for a Large Hospital
A prominent hospital was involved in a legal dispute with a payer over denied claims. Our team conducted an exhaustive review of billing records, identified discrepancies, and provided expert testimony. With our support, the hospital successfully negotiated a settlement, recovering 85% of the disputed claims.