We successfully defended a national home healthcare provider in appealing an $18 million extrapolated overpayment resulting from a UPIC audit. Through the Medicare claims appeals process, Bass Berry successfully argued that the vast majority of the claims denials should be reversed as they represented medically necessary care to homebound beneficiaries that was adequately supported by appropriate medical record documentation. The overpayment was reduced to $7 million at reconsideration. At the ALJ level of appeal, we were successful in getting every single claim appealed resolved favorably. This resulted in a multi-million dollar refund, including interest, to our client.
Successful Defense of National Home Healthcare Provider in Appealing $18 Million Extrapolated Overpayment Resulting from UPIC Audit
Client Type: Public Company