Examining the threshold for legal intervention and lessons from the courts
In recent years, Medicare providers across the United States have faced a rising number of audit notices alleging overpayments—sometimes for relatively modest sums such as $25,000, $30,000, or even less. This trend presents a dilemma for providers: the cost of legal representation often exceeds…
Healthcare providers have long navigated the complex world of Medicare audits, working diligently to meet billing standards, document patient care thoroughly, and respond to regulatory oversight. What once existed as a strictly administrative process is now evolving into something far more serious—and punitive. Increasingly, providers are finding themselves at the intersection of standard Medicare audits…
In the ever-evolving world of Medicare audits, 2025 is shaping up to be a year of Alice’s wonderland. Enter stage right: Artificial Intelligence (AI), a sleek, analytical wonderland where data reigns supreme and human error is no longer allowed to slip through the cracks. If you’ve ever found yourself lost in the tangled forest of…
The Medicare and Medicaid provider auditing process is about to get its own makeover in 2025. I am talking about artificial intelligence, which will be more accurate than our auditors pre-2025. The Medicare provider auditing process has evolved significantly in recent years, and several key trends are expected to shape the landscape in 2025. These…
