When a third party conducts an audit, they get to keep a percentage of the money they recover. They may even claim that some of their audits result in discovering … Continued

Please note the significant difference between evidence in medical malpractice trials and administrative licensure hearings within most states: Administrative licensure hearings generally admit hearsay; while trial courts usually do not … Continued

Since 2005, all Medicaid providers that make at least $5 million dollars annually, are required to have a written compliance program. Have a Happy and Healthy New Year!

You should periodically review your own bills and medical records to make sure that you know what is leaving your office under your signature. Please remember, that when you sign … Continued

Increasingly, we are seeing health care providers being subject to video evidence taken in public areas of hospitals and healthcare facilities. On more than one occasion, during the investigation by … Continued

Delays in response or non-response to your complaints in lack of coverage: Constantly kicking the can down the road, is not a legitimate response. Making you, the provider go in … Continued

Some insurance companies are taking certain procedures and refusing to pay out claims by labeling them as investigative. By doing so, this takes the claim out of certain types of … Continued

For those of you that take UDT, urine drug tests, be aware that you must justify the frequency of the tests. Is your patient a low, medium, or high risk … Continued

A physician, dentist, or any other healthcare provider that lost privileges, or got terminated for refusing a required COVID-19 vaccination can be reported by their hospital or practice to the … Continued