Insurance Audit Strategy & Negotiations
When your company gets an audit notice from a commercial payor, many providers think it will just be easier and faster to respond to the audit, often failing to consult with legal counsel before doing so. As a result, they end up with a red flag, a full medical records audit, a large overpayment demand, and sometimes years of negotiations during which funds they are owed are held hostage as a negotiating tool.
At Oppenheim Law, we have extensive experience in helping providers navigate complex audit requests, identifying what records should be produced, reviewing third party reviewer reports, and helping providers fashion appropriate rebuttals of such reports to negotiating favorable and fair outcomes. Specializing in handling audits for mental health and substance abuse facilities, we have the knowledge and experience to help your organization handle and clear audits without losing focus on providing care to patients.