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San Diego medicaid audits lawyers

If you are a healthcare provider and your practice has come under scrutiny in a Medicaid audit, you need an experienced healthcare lawyer to represent you. At Raiser & Kenniff, we are experienced with healthcare law and we bring our expertise to the assistance of both sole practitioners and large medical practices. With all our experience, we have learned that there are many different types of Medicaid audits a healthcare practice can face. Different approaches are necessary for different types of audit depending on what organization or contractor is handling the audit.

The Medicaid Integrity Program and fraud prevention

Medicaid audits are conducted to make sure that healthcare providers are not engaging in fraudulent activity by overcharging Medicaid for services for a patient. The Medicaid Integrity Program was implemented to ensure that Medicaid fraud can be identified and prevented. However, there are many different audit contractors that could engage in fraud prevention efforts by initiating an audit. Just a few of the relevant medicaid auditors are Recovery Audit Contractors, Comprehensive Error Rate Testing programs, and Medicaid integrity Contractors. An audit can also be initiated by a private insurance company.

Thus, there are many different types of Medicaid Integrity Contractor out there. However, all of these contractors fall under one three categories. there exist review Medicaid Integrity Contractors, educational Medicaid Integrity Contractors, and audit Medicaid Integrity contractors. Each of these three different types of contractor serves a different purpose in the process of conducting an audit on a healthcare provider charging Medicaid.

Those who provide medical services need to understand the complexity of the audit process when it comes to Medicaid. Handling an audit for a client requires not only a knowledge of administrative law, but also an understanding of how state and federal law also combine to affect the administrative aspects of the case in question. An audit can have devastating consequences for a healthcare practice if it is not handled properly. Doctors and other healthcare professionals need to recognize the fact that their livelihood is on the line if they are facing an audit. Expert legal counsel is therefore of enormous importance.

Responding to an audit

The following are four important tips for healthcare providers who are currently facing a Medicaid audit and need to find legal counsel for assistance:

Act quickly- It’s very important to respond right away to an audit. Waiting until close to any due dates that go along with your audit can put you at risk of neglecting to include some vitally important information. Due dates are important for auditors and any required information must be sent in to The Agency For Health Care Administration (AHCA) by the due date to avoid penalties.

Acquire a copy of all submitted claims- Keeping careful records of Medicaid claims is important because of the possibility of an audit. When you face an audit, you need to be able to quickly and conveniently come up with documentation of all of your claims.

Single out and develop explanation on any particular patient record that might incite scrutiny- If you already know that certain claims might receive particular scrutiny, single out these claims and include written information that you can present to your legal counsel and to the AHCA when necessary.

Compile information necessary for the Medicaid Provider Questionnaire- The Medicaid Provider Questionnaire is necessary in responding to an audit. You’ll need to make sure that every section on the form is filled out before submitting it to the AHCA in response to your audit.

Of course, the most important thing to do after you have been notified that you’re being audited is contact us. We are a New York law firm specialized in healthcare law.


Charle Butler
Charle Butler
2021-03-12
Verified
I was hesitant to hire the Spodek Law Group. I read reviews and knew they have a great reputation. However, I thought I would spend money and not see or speak to my attorney. From the beginning to end of my case Todd and the entire staff were available and willing to help. We worked towards and end result that was way above my expectation and Todd delivered. I am forever grateful for patience and long days and night spent working on my case. Thanks Todd and the entire team!
Mesonista parsons
Mesonista parsons
2021-03-05
Verified
My attorney at Spodek was Abigail. She was very knowledgeable and helpful with all my questions and concerns, as well as responsive. Her fees are affordable and Abigail took the time to make sure I understood everything relating to my case. I highly recommend Abigail and will request her services in the future.
debabrata chakraborty
debabrata chakraborty
2021-03-03
Verified
Todd A Spodek is the experienced and best criminal lawyer at USA. He is very professional and always respond on time. Alex also very cooperative and always help me. They took care me and my problem like family member. I am 100% satisfied for their professional service. My result was unexpected and amazing. They dismissed my case. I am really grateful to them. I will recommend you to go there if you want to solve your problem. I wish all the best for them.
Asata Hendricks
Asata Hendricks
2021-03-02
Verified
Truly appreciate the work the guys did!. Exceptional team & I know they care about each and everyone of their clients. I am super thankful to be referred to Spodek Law Group and I am grateful Todd & Alex were able to work diligently to achieve an outcome I am pleased with. Despite COVID they stayed on top of things and kept me informed every step of the way. Very thankful.
Mike Moroff
Mike Moroff
2021-02-26
Verified
I'm very satisfied with the services rendered by Todd, Alex and Mary Lou. I whole heartedly recommend Spodek Law Group . I've worked with and have retained other attorneys in the past with Todd's firm being the cream of the crop for many reasons. A very serious legal matter was resolved after a year's hard work and effort. Todd expertly guided me through the process and was able to navigate and make the good journey bearable as well as successful. Mary Lou initially provided excellent assistance before referring my case to Todd. Alex's support was effective and timely. The customer portal (MyCase) is an invaluable communication tool that also kept track of my case. Various aspects of my case were explained and there were several options provided but I made the final decision of how the case would be handled. The legal fee was reasonable considering the effort and amount of work plus it was a flat fee regardless of the length of time required to conclude my case. Todd made himself available to me and we had many scheduled meetings to go over the progress and to discuss the next steps. I felt more confident after many discussions with him. You will not go wrong choosing Spodek Law Group for legal matters.
Josh Katz
Josh Katz
2021-02-24
Verified
Being that it was the first time that I was in need of an attorney, I was afraid and hesitant and knew I needed the absolute best. It is beyond understood why Spodek Law Group has a reputation of being the top, if not the best law firm in New York. Alex and Abigail were there every step of the way even at the most unconvenient hours. I could not have asked for more. They are extremely good at what they do and they delivered much much more than just winning my case. A big thank you to Alex and Abigail for all the guidance and counseling and their upmost loyal support that extended far more than just legally. If you need the absolute best than don't hesitate to hire Spodek Law Firm.
L.C.
L.C.
2021-02-24
Verified
I cannot tell you how thankful I am to Todd and Alex for their hard work and dedication to my case. I had never been in any trouble before but I had an unfortunate event occur and in the midst of COVID-19 at that therefore I knew I needed a team that was dedicated to my success. Today- my case has been finalized and I’m walking away with no record and can continue life as a mother and a Grad student worry free. I cannot express enough gratitude for their assistance.
AnnMarie Soliman
AnnMarie Soliman
2021-02-23
Verified
I received a summons and called Spodek law group for a free consultation. Alex took my call and was very quick and responsive. He was available anytime through multiple platforms and very reassuring when needed. They are extremely organized and thorough. They got my case dismissed! I’m very grateful. Thank you Alex and Todd!

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"Spodek Law Group have offered me excellent support and advice thru a very difficult time. I feel I've dealt with someone who truly cares and wants the best outcome for you and yours. I'm extremely grateful for all the help Spodek Law Group has offered me. I can't recommend them..."

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"Spodek Law Group was incredibly professional and has given me the best advice I could wish for. They had been helpful and empathetic to my stressful situation. Would highly recommend Spodek Law Group to anyone I meet."

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"Best service I ever had. Todd is absolutely class personified. You are in the safest hands with spodek. They have their clients interest in mind."

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