Knowledge – Experience –Integrity

Medicare and Medicaid Reimbursement

The attorneys at Nicholson & Eastin, LLP regularly represent health care providers in prepayment and post-payment audits, as well as onsite inspections by Medicare contractors, and the appeal of claims denials.

The proper handling of responses to development letters can be critical in ensuring the proper adjudication of claims and in preserving appeal rights. Denials of claims by Medicare and Medicaid in pre- and post-payment audits are often inaccurate, and claims denials should be closely examined and appealed if the denial was erroneous. We also represent providers in payment disputes with private health insurance carriers.

Nicholson & Eastin, LLP works with a variety of coding experts to educate providers when claims are being denied because of coding and documentation errors.

In the case of a self-audit that results in the identification of an overpayment, we assist providers in evaluating the overpayment and making the necessary self disclosure to Medicare.

Nicholson & Eastin, LLP also assists providers in establishing and evaluating their Medicare and Medicaid compliance efforts.

Please contact us today if you are in need of assistance with a payment dispute with Medicare, Medicaid or a private insurance company.