Every clawback deserves a rebuttal.
When a payer alleges overpayment, we analyze the full claims record and build the evidence your attorneys file.
Within one business day we tell you what kind of review it is, the deadlines stated in it, and where the payer’s numbers look weak. Send it with patient details removed.
Built with healthcare attorneys · Line-level, defensible, audit-ready
An allegation is an extrapolation, not a finding.
Payers sample a few dozen claims, find error, and project it across years of billing. The projection is only as sound as the sample. We rebuild the record line by line, the coding, the documentation, the medical necessity, and show where the sample does not carry the conclusion.
A Medicare recoupment, rebuilt claim by claim. Not every matter moves that far.
On the unpaid-claims side, a clinical lab’s decade-long case against a Blue Cross plan went to trial and the lab won.
Every line, not the sample
We work from the complete extract, not the payer’s sample: every line, every modifier, every remittance.
Evidence, line by line
Each disputed line is traced back to the documentation that supports it, and cited.
Ready for counsel to file
Findings arrive in the form your attorneys file: reproducible, sourced, and defensible under challenge.
In claims analyzed
Claim lines analyzed
Payer organizations
On the provider’s side, and no one else’s.
We do not take payer engagements. Health systems, physician groups, and the law firms defending them are the whole of our practice.
Every clawback deserves a rebuttal.
Send us the allegation letter, with patient details removed. We will tell you what the data says.