Third Party Payer Audit Defense
Refund demands often involve significant amounts of money and typically come years after the services have been rendered and payment has been made. Effective legal counsel is necessary to navigate the appeal process.
We defend healthcare clients from demands for refunds from:
- Private third party insurance payers.
- Certificate of Need
- Compliance with Federal and State Laws and Regulations
- Fraud and Abuse/Physician Self-Referral (Stark Law) and Anti-Kickback
- Licensing Issues
- Litigation Involving Physicians/Ancillary Healthcare Providers/Suppliers
- Physician/Ancillary Healthcare Provider/Supplier Entity Formation and Physician Group Structuring