Frier Levitt Successfully Reduces Multiple Overpayment Demands

Recently, Frier Levitt successfully reduced significant overpayment demands for three (3) different practices.  In one overpayment demand from a major payor, Frier Levitt was able to reduce the overpayment demand by over $1.6 million.  In another case, Frier Levitt’s efforts decreased the overpayment demand by over $330,000. Lastly, in one other matter, Frier Levitt achieved a nearly 70% reduction of the original overpayment demand.

Healthcare providers across the nation are facing increasingly aggressive auditing from public payors like the CMS and Medicaid Managed Care Organizations, and private payors. Insurance companies are conducting audits at an unprecedented pace, often leading to significant overpayment demands based on seemingly minor documentation errors, billing discrepancies, or even oversights in credentialing. These demands can be financially crippling, jeopardizing the stability and reputation of even well-established practices.

Use of extrapolation by insurance companies can inflate minor issues into exorbitant overpayment demands, creating a sense of helplessness for providers. This can be particularly detrimental for smaller practices with limited resources to fight back. Frier Levitt’s extensive experience in defending medical audits over the years has achieved remarkable outcomes for clients. Recently, Frier Levitt successfully represented three medical practices that were confronted with substantial overpayment demands from a major insurance plan.

In one matter, Frier Levitt secured a significant reduction of $1.6 million in an overpayment after closely collaborating with the medical practice to challenge the audit findings and rectify documentation discrepancies.

In a separate case, Frier Levitt attorneys achieved a nearly $330,000.00 reduction through collaboration with an independent expert coder who assisted in disputing inconsistencies, demonstrating compliance with billing requirements, and clarifying discrepancies in the documentation.

In one other matter, Frier Levitt achieved a nearly 70% reduction of the original overpayment through disputing inconsistencies and clarifying documentation discrepancies with use of attestations.

As the provided examples demonstrate, substantial reductions in overpayment demands – even exceeding $1 million – are possible with strategic legal assistance.

Frier Levitt attorneys represent healthcare providers in pre-payment and post-payment audits, including cases with significant overpayment demands.  Our attorneys are well-equipped to handle the legal challenges posed by audits and overpayment demands.  We frequently appear before Administrative Law Judges (“ALJs”) on Medicare matters and work closely with the legal department of most major payors.  

If your medical practice receives an audit or overpayment demand, it is crucial to seek the guidance of an attorney who specializes in healthcare law. Do not wait until you receive an overpayment demand or adverse findings. Early intervention is crucial, as it allows for a proactive approach and increases the likelihood of a successful outcome.

Contact Frier Levitt today to speak with an attorney who can provide the necessary support to navigate through these complex situations and protect the interests of your practice.

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