Unified Program Integrity Contractor (UPIC), Recovery Audit Contractor (RAC), Medicare Administrative Contractor (MAC), Comprehensive Error Rate Testing (CERT), and Target Probe Educate (TPE) matters across Part B, including high risk areas like skin substitutes, Durable Medical Equipment (DME), and Home Health.

Defense in payer audits involving medical necessity, documentation standards, and billing compliance issues.

Structured analysis of denial rationale with development of defensible response strategies.

Appeal positioning aligned with payer requirements, Medicare contractor expectations, and the clinical record.

Assessment of sampling, error rates, and extrapolation methodology in overpayment matters.

Targeted review of claims for documentation, coding alignment, and defensible payment support.

Ongoing compliance oversight, audit preparedness, and focused risk mitigation support.

Subject Matter Expert support for complex audit matters, regulatory interpretation, and litigation-related needs.

Identification of billing vulnerabilities and alignment with coverage and documentation requirements.