Medicare & Medicaid Reimbursement

The attorneys at Nicholson & Eastin, LLP regularly represent healthcare providers in prepayment and post-payment audits, as well as on-site inspections by Medicare contractors, and the appeal of claims denials. We work to give our clients in the healthcare industry the most effective analysis, advice, and litigation of Medicare and Medicaid reimbursement issues.

Nicholson & Eastin Florida Health Care Attorneys

Medicare and Medicaid can be very complex and require the help of highly experienced health care attorneys.

Founded by attorneys Robert Nicholson and Parker Eastin, the law firm focuses on the representation of clients health law advice, health care regulatory matters, government investigations and in white collar criminal defense.

Responding to Medicare and Medicaid Claim Denials in Florida

The proper handling of responses to development letters can be critical in ensuring the proper adjudication of claims and in preserving appeal rights. Denials of claims by Medicare and Medicaid in pre- and post-payment audits are often inaccurate, and claims denials should be closely examined and appealed if the denial was erroneous. We also represent providers in payment disputes with private health insurance carriers.

Nicholson & Eastin, LLP works with a variety of coding experts to educate providers when claims are being denied because of coding and documentation errors.

In the case of a self-audit that results in the identification of an overpayment, we assist providers in evaluating the overpayment and making the necessary self-disclosure to Medicare.

We represent clients in:

  • Professional licensure actions.
  • Government investigations at all levels.
  • Health care transactions, such as mergers and acquisitions.
  • Practice and facility licensing through AHCA and related entities, as well as AHCA and DOH exemption matters.
  • HHS-OIG Civil Monetary Penalty and Exclusion Actions.
  • Medicare, Medicaid, and commercial health insurance enrollment and payment disputes, overpayments, claims appeals, and prepayment reviews.
  • Compliance guidance and compliance plans.
  • Internal investigations and HIPAA data breach assessments.
  • Litigation relating to health care regulations and related matters, whether before administrative tribunals, civil disputes, or white-collar criminal defense of licensed professionals in state and federal courts.

Medicare and Medicaid payments, audits, overpayments, appeals, exclusions and revocation of provider status in Florida

In matters regarding Medicare or Medicaid audits or fraud allegations, it is crucial to quickly find a lawyer with subject expertise. A lawyer with the right background can effectively aid your practice when facing audits, appeals, and revocations. Since these agencies often issue time-sensitive notices, it is critical to act as fast as possible.

Medicare and Medicaid billings and reimbursements are packed with regulatory compliance requirements. These issues can be complicated and often involve billing by any provider from physicians to hospitals. Having an attorney who can help you facilitate navigate being accused of Medicare fraud or overpayments, can help you succeed. The attorneys at Nicholson & Eastin, LLP work closely with clients to find the most efficient and effective strategy for handling all Medicare and Medicaid matters. Our extensive background in the healthcare space gives us the experience necessary to wisely navigate complex questions and issues and the ability to forcefully advocate on behalf of our clients.

medicaid reimburstment attorney in fl

Contact us immediately if you have received a notice from any of the following agencies:

  • The Centers for Medicare and Medicaid Services(CMS), which administers the Medicare and Medicaid programs at the federal level
  • The Office of Inspector General of the federal Department of Health and Human Services(OIG), which has the authority to permanently exclude you from federally funded healthcare programs
  • First Coast Service Options(FCSO), a subsidiary of Blue Cross and Blue Shield of Florida, which serves as the Medicare Administrative Contractor (MAC) for Medicare in Florida
  • The Agency for Healthcare Administration(AHCA), which administers the Medicaid program in Florida
  • A Recovery Audit Contractor for Medicaid(RAC), such as Connolly Consulting in Florida
  • A Zone Protective Independent Contractor for Medicare(ZPIC), such as SafeGuard Services in Florida
  • A Medicare or Medicaid Managed Care Organization (MCO)

Seek The Advice of Counsel

Nicholson & Eastin, LLP also assists providers in establishing and evaluating their Medicare and Medicaid compliance efforts.

Please contact us today if you are in need of assistance with a payment dispute with Medicare, Medicaid or a private insurance company.

Contact Nicholson & Eastin

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