We deliver solutions that prepare, prevent, or guide healthcare providers and provider groups through the process of a UPIC Audit or Investigation. This includes preventative data analytics, medical review, practice management, and unmatched industry knowledge should a healthcare provider or practice be a target of a UPIC action.
Administrative actions used against a healthcare provider to recover money paid or prevent money from being paid by the government for services rendered. We provide consulting strategies to prevent administrative and/or legal actions from being imposed.
We assist in conducting an internal audit, including medical review of claims to determine the best strategy for preventing administrative actions and how to respond when actions are taken against a healthcare provider.
We assist in drafting appeals and rebuttals to CMS implemented payment suspensions, revocations, pre-payment reviews, overpayments, or other actions that may be taken against a provider or healthcare practice.
Our experts provide resources and referral services during the criminal and/or civil investigation processes.
The Justice Group Consulting has over 100 years of combined experience investigating, protecting, and guiding medical practices to ensure their billing procedures are optimally performing. Interruptions in processing claims or payments can be devastating to a practice. We are well versed in claims, appeals, and rebuttals and can thoroughly investigate billing procedures to develop and implement corrective plans.
