How can an audit affect a physician?

Medical professionals work each day to ensure that individuals are in a healthy state. Since they take care of others, they also have to bill them for the care that they give to them. These healthcare professionals may be scrutinized for the amount that they charge for their service. If they are being audited, their prices that they have billed for can be inspected. HMOs and the government may go through routine audits to recover money that has been paid to physicians for health care. For these cases, the insurer may ask for money to be recovered that was overbilled in the first place. This can be a difficult situation for physicians. They should seek legal advice before ensuing in the battle for the money.

As a physician, how do I settle a claim?

When physicians are blamed for overcharging on their bills, they should seek an auditor themselves to aid with their defense. By having their own auditor to go through the claims made by the insurer’s auditor, it can help them retain the money for their services. The physician will have to show that the audit was not reliable and that the allegations are not supported. They may even have instances where underpayments were made and that can be used as well. This information can all be used to drive down the percentage that the insurer claims is owed back to them.

While individuals may find that some doctor’s bills are costly, this is to provide the best available care for them. Care comes at a cost. If the doctor believes that the claims are false, they may have the opportunity to prove so with their own audit. This can help support them and show that the insurer’s claims are not backed up with evidence. An audit can reveal costs that the doctor should be aware of. Money can lead to sticky situations. Doctors should make sure to acquire legal help when faced with these claims. They are the professionals in health care and need the same professional support for legal matters. Our attorneys can guide doctors toward the most beneficial solution.

When a medical professional is accused of misconduct, it is essential that they retain strong legal representation. If you require a medical law attorney for your legal matters, call Paul E. Walker, an experienced New York City OPMC & OPD Lawyer. Please contact the Walker Medical Law firm to set up a free initial consultation.