• Menu
  • Skip to primary navigation
  • Skip to main content

Health Care Lawyers - Ismail Laher Helping Providers Nationwide with (Medicare) Audits and Investigations

Ish Laher and the Attorneys at Liles Parker, PLLC represent Health Care Providers nationwide. We handles Medicare Audits Defense, Medicare Prepayment and Over Payment issues, CMS Suspension and Revocation Actions,, Compliance Plans, Hippa & Osha Mandatory Training

  • Webinars
  • Violations & Convictions
  • UPIC’s
  • Suspension Actions
  • Revocation Issues
  • RACs – Recovery Audit Contractors
  • Post Payment Reviews
  • Pre Payment Reviews
  • Ish – Ismail Laher & Team
  • Hipaa
  • Webinars
  • Violations & Convictions
  • UPIC’s
  • Suspension Actions
  • Revocation Issues
  • RACs – Recovery Audit Contractors
  • Post Payment Reviews
  • Pre Payment Reviews
  • Ish – Ismail Laher & Team
  • Hipaa

Pre Payment Reviews

CMS has directed its contractors to focus on preventing the payment of improper claims.

September 3, 2015 //  by AdminL

CMS has directed its contractors to focus on preventing the payment of improper claims.
“Pay and Chase” practices are discouraged.
CMS contractors have been tasked with the responsibility of developing innovative data analysis methodologies for detecting and preventing Medicare fraud and abuse.

Category: General, Pre Payment ReviewsTag: Pre Payment Reviews

Pre Payment & Post Payment Review – Typical Audit issues

September 2, 2015 //  by AdminL

Auditors are “missing” vital documentation submitted in response to their request for documents.
In complex medical cases, auditors are citing medical journal findings which are not the current state of the science.
Auditors are using a “cookie cutter” approach when extrapolating damages, failing to take into account the specific characteristics of a given case.
Auditors are readily substituting their medical judgment for that of a treating physician.
Auditors are conducting “interviews” of patients in an effort to determined if the patient was homebound (sometimes as much as a year after the dates of service at issue), and are then denying claims based on these present interviews.
Auditors are applying the wrong LCD when assessing coverage requirements.
Auditors are supposedly comparing a provider’s billing practices to those of his alleged peers despite the fact that the provider’s specialty area was completely different from that of the other providers cited.

Category: General, Post Payment Reviews, Pre Payment ReviewsTag: Post Payment Reviews, Pre Payment Reviews

  • Go to page 1
  • Go to page 2
  • Go to page 3
  • Interim pages omitted …
  • Go to page 5
  • Go to Next Page »

Deprecated: genesis_footer_creds_text is deprecated since version 3.1.0! Use genesis_pre_get_option_footer_text instead. This filter is no longer supported. You can now modify your footer text using the Theme Settings. in /home/medicala/public_html/wp-includes/functions.php on line 5094

Copyright © 2023 · Mai Law Pro on Genesis Framework · WordPress · Log in