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Medicare Hearings and Appeals

 

medicare hearings and appeals

Has Medicare, Medicaid or a Private Payor asked you to provide copies of charts or special attachments to your claims?

Have you received a determination of overpayment or already had funds recouped from your practice?

No matter what stage of an audit you may be in, we can help. Our Certified Professional Coders (CPC's), Certified Compliance Professionals (CCP's) and healthcare consulting team provide both support and representation during an audit through the following services:

  • Research all regulations in effect regarding the services in question during the audit time period.
  • Perform a "shadow audit" and review the same charts that the payor selected.
  • Provide a written opinion and even re-calculate the overpayment based on our findings.
  • Educate you and your staff on the process and steps involved in a review and appeal.
  • Provide expert testimony based on our findings during a hearing.
  • Provide documentation which supports our findings to the carrier.
  • Work closely with your attorney or provide legal contacts where needed.


Kerkering Barberio's Medical Consultants have years of coding and billing experience as well as experience working in carrier and intermediary audit and education departments. Our successful track record includes overturned audit decisions and repayment to providers such as: physicians, imaging centers, radiology providers, surgery centers, physical therapists, dialysis clinics, radiation therapy, and waiver providers.

Turn to us during any type of payor audit situation to alleviate the administrative burden and the worry.


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