We successfully defended a home health agency in appealing a $9.3 million extrapolated overpayment resulting from a Zone Program Integrity Contractor (“ZPIC”) audit. Through the Medicare claims appeal process, we successfully argued that the statistical sampling methodology was invalid and should be set aside, resulting in the demand being reduced to under $175,000 before individual claims arguments were considered.
Successful Defense of Home Health Agency in Overturning Extrapolated Overpayment Resulting from Medicare Claims Audit
Successful Defense of Home Health Agency in Overturning Extrapolated Overpayment Resulting from Medicare Claims Audit
We successfully defended a home health agency in appealing a $9.3 million extrapolated overpayment resulting from a Zone Program Integrity Contractor (“ZPIC”) audit. Through the Medicare claims appeal process, we successfully argued that the statistical sampling methodology was invalid and should be set aside, resulting in the demand being reduced to under $175,000 before individual claims arguments were considered.