Medicare and Medicaid

Our Medicare and Medicaid attorneys can help you when facing a government audit. With the current depletion of the Medicare and Medicaid programs, government audits of health care providers are on the rise. These audits often target Medicare and Medicaid payments and billing practices. They are designed to investigate and find overpayments or fraud.

At Hagwood & Tipton, our Medicare and Medicaid reimbursement attorneys understand the importance of addressing audits of your entity. Our knowledge and familiarity with the audit process allow us to provide the detailed guidance you need to understand and resolve disputed overpayments quickly and cost effectively.

Medicare and Medicaid Services

RAC, MAC, MIC, ZPIC, and UPIC Medical Audit and Appeals Attorneys

Working on a contingency-fee basis, Recovery Audit Contractors (RACs) are motivated by financial gain to examine Medicare and Medicaid claims filed by hospitals, nursing homes, long-term care providers, hospice, home health and therapy companies, medical clinics, physician practices, and all other health care providers. These auditors carefully examine all records of your claims in an effort to discover overpayments, incorrect payments, improperly coded payments or fraudulent billing of the government programs. We provide advice during the audit process to help preserve your rights and to follow proper strategies for complying with the auditor’s demands for information. Similar to the RAC, the MAC, MIC, ZPIC and UPICs follow the same desire to find overpayments or fraud. Prior to audits, our health care attorneys offer strategic advice and planning that help you to avoid the inconvenience and expense of an investigation, including:

  • Establishing a reporting system that allows you to quickly provide information to RACs, MACs, MICs, ZPICs and UPICs
  • Monitoring payment claims and other areas that fall under RAC, MAC, MIC, ZPIC and UPIC supervision
  • Maintaining compliance with all government programs
  • Maintaining knowledge of claim denial and appeal proceedings

Assertive Appeals Representation

Following an audit, you may be ordered to repay Medicare or Medicaid claims. We provide assertive appeals guidance in an effort to help you avoid a government take-back and unnecessary expense. Whether you wish to appeal the RAC, MAC, MIC, ZPIC or UPIC decision or work out a suitable payment arrangement, we will work diligently until your case has been resolved in an appropriate manner.