Medical records that tend to have obvious or nearly identical documentation.Claim records that do not match doctor’s records.Long inpatient stays (hospice providers and long-term care providers are most at risk).Billing trends that fall outside of the industry standard.Having a greater frequency of high-end services compared to local or national patterns.Make sure you are billing Medicare correctly and maintaining the required documentation.Įrrors in level-of-care billing and coding can also trigger a UPIC audit, so ensure that your inpatient stays are coded correctly. Facing a Medicare Audit or Investigation? Put Proven Lawyers on Your Side.īilling mistakes and overpayment can easily trigger a UPIC audit, especially for hospice care, home health agencies, long-term care, and durable medical equipment (DME) providers.Defending Medicare Providers and DME Suppliers Against UPIC Audits.What Are the Possible Consequences of a Medicare UPIC Audit?.What to Expect from a Medicare UPIC Audit.Do I Need A Lawyer To Respond To A UPIC Audit?.What Should I Do If I Receive A Letter From A UPIC, Such as Qlarant?.What Is the Difference Between UPIC and ZPIC?.Our Houston-based attorneys serve clients nationwide. The focus of the UPIC audit is to determine the extent of the alleged fraud, waste, or abuse and take appropriate action.Ĭall (713) 909-7323 to get started on your defense. They initiate focused reviews, medical record requests, and interviews to gather evidence and establish the facts in suspected cases of fraud, waste, or abuse. UPICs, such as Qlarant and SafeGuard Services, do not conduct random audits. If you get a letter from a UPIC, you are already under investigation. The Centers for Medicare & Medicaid Services (CMS) created the Unified Program Integrity Contractors (UPIC) program to investigate suspected fraud and abuse associated with Medicare Parts A and B, Durable Medical Equipment (DME), Home Health and Hospice (HH+H), and Medicaid. Medicare UPIC Audit Defense Lawyers in Houston Qlarant Investigation & Audit Defense Digital Millennium Copyright Act (DMCA).Intellectual Property Protection on Social Media.Social Media Policies & Employee Training. Social Media Compliance for Regulated Businesses.Will OSHA Think I'm Guilty if I Hire a Lawyer?.Doing Business with a Client in Chapter 11.Concierge and Direct Primary Care Practices.Medicare Billing Privilege Revocations & Appeals.Corporate Practice of Medicine Doctrine.Intellectual Property & Trade Secret Protection.Confidentiality or Non-Disclosure Agreements.
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