Successful Audit Appeal for Vein and Vascular Client

We represented a provider in the vein and vascular space in successfully appealing an audit, which utilized a statistically valid random sample to calculate an extrapolated overpayment of $1.2 million. Following the first level of appeal, we secured a reversal of the majority of the denials, resulting in a reduction in the overpayment to less than $350—roughly 0.03% of the original extrapolated overpayment amount—and a refund of the amounts previously recouped.

This result underscores the importance of a robust and thorough appeal strategy. Our team navigates this process efficiently, engaging clinical and statistical experts as needed, to defend flawed claims denials.

We represented a provider in the vein and vascular space in successfully appealing an audit, which utilized a statistically valid random sample to calculate an extrapolated overpayment of $1.2 million. Following the first level of appeal, we secured a reversal of the majority of the denials, resulting in a reduction in the overpayment to less than $350—roughly 0.03% of the original extrapolated overpayment amount—and a refund of the amounts previously recouped.

This result underscores the importance of a robust and thorough appeal strategy. Our team navigates this process efficiently, engaging clinical and statistical experts as needed, to defend flawed claims denials.