Fraud & Forensic Services
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Healthcare fraud has become an issue affecting patients, providers, governments, and taxpayers and is estimated to cost $68 billion annually to the nation. At Healthcare Medical Billing Solutions, LLC, we work with you to look for fraud and abuse through forensic auditing. With over 60 years of combined knowledge, we follow the paper trail and get to the root actions of the abuse or fraud.
We specifically look for compliance within the Healthcare industry set forth by the OIG and Medicare. During the audit process, we hone in on suspicious overpayments, coding issues, billing patterns and assure our clients that all billing guidelines are fulfilled correctly.
Our experience includes working with medical providers, billing companies, government officials, and insurance companies. Our past results include recovering over $200,000 dollars for a provider group owed to them by the insurance company.
Another client retained our services due to not being credentialed properly and subpar billing practices, as a result, they were not able to obtain sufficient cash flow for operating costs. As a result of the company not being set up properly and 3 billing companies filing improperly for 3 consecutive years, they were only able to collect no more than $300,000 per year. HMBS, LLC was able to rectify the very complex structure of the company and recovered $150,000 retroactively for the prior 6 months with $140,000 from Medicare for which the company had never submitted claims.