THE REAL COST OF MEDICAL NECESSITY REVIEWS
How to Protect Your Physician Clients
If you are a healthcare attorney with a physician client who is facing a post-payment, medical necessity carrier review, a third-party audit can prove to be an invaluable resource.
Carriers are using medical necessity of services provided as the basis for their audits at an alarming rate. It’s important to remember that the individual who performed the audit of your client is an employee of the carrier. This may seem obvious, however, given this fact it is imperative to question whether an employee of the organization seeking recoupment can perform an audit that is truly unbiased.
Giving your client the benefit of an independent audit performed by an experienced medical auditor, not only levels the playing field, but can offset the cost by the potential appeal and reconsideration made viable through the independent review process.
A third-party auditor with experience in supporting defense cases will clarify whether the carrier’s audit is truly unbiased.
Our commitment to you and your client
Our mission is to provide a truly an unbiased audit of medical necessity cases to protect providers against repayment demands based on a one-sided review. Our auditing team has performed thousands of audits. They deliver reports that remove all interpretation and opinion and present factual assessments of a review. Each of our auditors has experience navigating the nebulous rules of medical necessity to expose any bias.
Choosing to forego an independent audit can be very costly.
When an independent audit identifies bias, which they often do, you can build the appropriate strategy to defend your client as well as restore and validate your client’s confidence in their medical necessity decisions as it relates to the rules. It also helps improve your track record of success.
As proven by our reputation in the industry since 1956, our straightforward approach with clients is to provide access to our fees. We don’t adjust our fees based on your case; we focus our mission on appropriately representing each and every client using a standardized fee schedule.
What to do next…
- Receive our 2018 Fee Schedule
Submit the form above and we’ll send you a link to download our 2018 Compliance Fee Schedule.
- Contact us to Learn More
Call 800-635-4040 or email us at email@example.com to discuss our audit and appeal support services.