RAC Audit Defense

Have you been the unlucky subject of a RAC audit?  Are you being subjected to extrapolated recoupments and penalties?

Before you simply capitulate and pay them, it would be prudent to confirm their findings.  Writing a small check to The Coding Network might eliminate or reduce a large check to these “bounty hunters.”  Their auditors may not be intimately familiar with your specialty, and their commission-only structure certainly gives them an incentive to assert that you’ve made coding errors or that your records don’t support your claims.  There may be some gray areas in your charts that they interpret against you.  We can audit the same encounters or operations they examined, and our findings may give you the ammunition you need to mount a credible defense.

Call 888-CODE-MED to learn more.

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Westside Los Angeles Dentist Being Sent To Prison

June 18th, 2019|Comments Off on Westside Los Angeles Dentist Being Sent To Prison

A West Los Angeles dental practitioner was sentenced last week to forty months in federal jail for a health-care insurance fraud scheme during which he submitted phony billings for crowns and fillings that were not [...]

Florida Physicians and Practice Settle False and Fraudulent Claims Case

June 18th, 2019|Comments Off on Florida Physicians and Practice Settle False and Fraudulent Claims Case

Jaime L. Sepulveda, MD, LLC (d/b/a Miami Urogynecology Center), Jaime L. Sepulveda, M.D., and Sujata Yavagal, M.D. (collectively, "Miami Urogynecology Center"), South Miami, Florida, entered into a $173,768.08 settlement agreement with OIG. The settlement agreement [...]

Connecticut Diagnostic Services Provider Settles Case Involving False Claims

June 14th, 2019|Comments Off on Connecticut Diagnostic Services Provider Settles Case Involving False Claims

On November 19, 2018, Southern Connecticut Vascular Center, LLC (SCVC), Stratford, Connecticut, entered into a $792,076.76 settlement agreement with OIG. The settlement agreement resolves allegations that SCVC submitted claims for Healthcare Common Procedure Coding System (HCPCS) [...]

California Physician and Practice Settle Case Involving False Claims

June 14th, 2019|Comments Off on California Physician and Practice Settle Case Involving False Claims

On December 20, 2018, Michael Jadali, D.O., and the Center for Pain & Rehabilitation Medicine (collectively, "Dr. Jadali"), San Jose, California, entered into a $60,406.30 settlement agreement with OIG. The settlement agreement resolves allegations that Dr. [...]