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San Diego Medicaid Healthcare Audit Lawyers

Medicaid is a government program that allows people who don’t have a large income to go to the doctor or to receive testing that they otherwise wouldn’t be able to afford. It can also be used to help pay for stays in the hospital or a nursing facility. Unfortunately, there are some concerns with medical offices when they have to audit doctors and other providers who tend to try to get more money from Medicaid.

A healthcare law firm represents everyone from dentists to hospitals who are involved with investigations and litigations. There are several issues that need to be addressed if someone is under an investigation with a Medicaid audit. The license of the doctor or nurse could be at risk as well as the license to operate at the office, nursing facility or the hospital. If the license is taken away, then the location would need to close until the issues have been remedied. Complete and organized records must be turned in to the audit team, and an attorney can help to ensure that these forms are completed like they should be so that the provider stands a better chance of remaining in business.

If a Provisional Agency Audit Report is received, it’s even more important to have all of the paperwork in order so that multiple payments to Medicaid are not made. This is a time to submit explanations for miscalculations, mistakes and other issues that have been reported. There are times that a demand for an over-payment might be requested. If the office or the provider has to pay back any money that has been received because there have been issues with getting more money from Medicaid, then it needs to be submitted as soon as possible so that it can be taken off of the record.

One of the ways that offices can get more money from Medicaid is to bill for multiple services that are provided when there is only one or two services that have been provided to patients. Some pharmacies will charge Medicaid for an expensive prescription while dispensing one that is less expensive. There are times when a pharmacy will bill for a medication that is expensive and give a patient that is completely different and cheaper but does the same thing as the one that is prescribed. Some doctors will submit codes for multiple services that were performed when they are supposed to submit combined codes. This is one of the common ways to get more from insurance companies like Medicaid. Most billing forms will combine common services, such as x-rays or blood work. The office would simply record individual services on multiple forms and change the date, making it look like there were several services that were provided for the patient on different days in order to get more money. If the patient doesn’t get a copy of the billing information from Medicaid, then the patient would never know that this was done.

Each dollar that is owed needs to be accounted for, and if the money can be shown, then it can end up saving the office hundreds in the final auditing process. This is where the attorney will be a benefit. The attorney can make sure the numbers that are recorded as they should be and that there are no errors with additions or subtractions. Other errors can also be discovered when the attorney looks at the paperwork that is submitted to the audit defense office. It could be something as simple as a number that needs to be changed or information about inventory that needs to be updated.


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..."

David Bruce

"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."

Rowlin Garcia

"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."

Francis Anim
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