How to Challenge an Extrapolated Medicare Overpayment
Extrapolation is when a Medicare contractor projects the error rate from a small random sample of claims across every claim you billed, which can turn a few denials into a six-figure demand. You can challenge it by attacking the statistical method or overturning the sample claim denials on appeal.
A Guide to Responding to a Medicare Additional Documentation Request (ADR)
If your practice just received a letter labeled “Additional Documentation Request,” you’re not alone — and you’re not necessarily in trouble yet. An ADR is one of the most common tools Medicare contractors use to review whether a claim was billed correctly. But how you respond in the coming weeks can determine whether that claim […]
What is the Line Between Medical Billing Errors and Healthcare Fraud?
Learn how federal law separates medical billing from from simple billing errors. You’ll discover the role of intent and the steps you can take to protect your healthcare practice during billing fraud investigations.