Claims Appeal Results in Reversal of Alleged Medicaid Overpayment

Posted on Firm News by Parker Eastin

After submitting a detailed appeal on behalf of our client’s medical practice, the Firm secured a complete reversal of an overpayment demand from the Medicaid contractor.  The Medicaid contractor initially challenged the coverage for the allergen immunotherapy services provided by the medical practice.  However, after addressing the support for the allergy services found in the relevant medical records, as well as the propriety of the medical practice’s historical use of properly-trained personnel under the direct supervision of a physician in the allergen immunotherapy context, the Medicaid contractor completely withdrew the overpayment demand.

The law firm of Nicholson &, Eastin, LLP, routinely represents individuals and medical group providers in the defense of Medicare, Medicaid, and commercial insurance overpayment appeals.  If you have received a request for records from a Medicare or Medicaid contractor, or an overpayment demand, please do not hesitate to contact us to evaluate your matter.