At Chilivis Grubman Dalbey & Warner LLP, our Georgia healthcare compliance attorneys can assist you in responding appropriately to audits by government agencies, government and private payor audit requests, Recovery Audit Contractor (RAC) investigations and other potentially costly regulatory actions. We also provide ongoing general counsel to healthcare professionals and organizations, helping them remain in compliance with the myriad regulations in the healthcare industry.
As a full-service healthcare law firm, we are prepared to provide you with the knowledgeable guidance and strong representation you need for audit and compliance issues.
Call (404) 233-4171 or contact us online if you need legal help with a healthcare audit.
The Recovery Audit Contractor (RAC) Program is conducted nationwide by the Centers for Medicare & Medicaid Services (CMS) and designed to identify improper payments by Medicare beneficiaries to healthcare providers. Issues targeted by RAC investigations include duplicate billing, Stark Violations, incident to billing errors and medical necessity issues.
RACs are motivated by profit to investigate and uncover evidence of overpayment to medical providers. An RAC investigation can place an onerous burden on your practice. However, you have rights and protections in this process. For instance, Medicare RAC investigations are limited to a three-year look-back period, and there is a limit to the number of records they can request within a certain time period. Also, they are prohibited from reviewing medical bills that were already investigated by another contractor.
Our attorneys can help you understand your rights and obligations in regard to RAC audits. We will apply our skill and experience in healthcare law to help you put this investigation behind you and avoid further regulatory and compliance problems.
Government and Private Overpayment Matters
Now more than ever, private and government health insurance payors are seeking to eliminate healthcare fraud, abuse and waste. As a result, many providers are faced with insurance audits resulting in demands for the repayment of insurance proceeds. Whether dealing with Blue Cross Blue Shield of Georgia (BCBSGA), Aetna, United Healthcare (“UHC”), Medicare or Georgia Medicaid, it is important to hire competent counsel to negotiate or litigate a favorable result.
Atlanta Physician Group Compliance, Overpayment and Audit Attorneys
If you face a healthcare audit and are seeking legal guidance, our law firm is here for you. Contact us today online or by telephone at (404) 233-4171 to arrange a consultation with an experienced Georgia lawyer.