Healthcare businesses and professionals face a lot of pitfalls and complexity with Medicare laws. If you have a question regarding this federal law, you will want to work with a Boca Raton Medicare attorney.

Medicare Enrollment

Healthcare businesses, physicians, and other professionals in the industry must be enrolled in Medicare to receive government payments for services provided to Medicare beneficiaries.

To enroll in Medicare, you must submit an application and provide the required documentation to prove that you are qualified to participate in the program. For example, physicians may be required to provide unique documentation for their practice, while medical suppliers and other non-physicians would have to complete documentation related to their business.

By enrolling in Medicare, you may be able to enjoy benefits like receiving a higher Medicare reimbursement and receiving Medicare payments directly.

Medicare Reimbursements

There can be many problems that arise with Medicare reimbursements. These can include the following:

  • Missed reimbursements
  • Miscalculating the amount of reimbursement due
  • Errors and incorrect information
  • Allegations of fraud

If there is a dispute over Medicare reimbursement, you will want contact a Boca Raton Medicare attorney. An experienced attorney can assist you and help you recover the amounts that you are entitled to, review documentation for missed opportunities for reimbursement, correct mistakes, and help fight allegations of fraud.

Medicare Audits

The Centers for Medicare and Medicaid has the ability to reopen any Medicare claim within 12 months of payment or within 36 months if they have a showing of good cause. What this means is that there is a good chance that the government will be auditing one of your claims.

Typically, the government will reopen claims by one of these methods:

  • Medicare Administrative Contractor. This is a local entity that can review any claim within 12 months for any, or no, reason.
  • Medicare Program Safeguard Contractor. Safeguard Contractors investigate suspected fraud and abuse. The Safeguard Contractor may determine if a case should be referred to law enforcement for criminal enforcement.
  • Office of the Inspector General. This office has broad powers to detect and investigate fraud in the Medicare system. The office evaluates the work of Administrative Contractors.

Contact Webb Millsap at the Health Law Firm of Florida

If you have a question about Medicare, you may want to discuss your issue with an experienced Florida healthcare lawyer. Contact Webb Millsaps and the Health Law Firm of Florida at (561) 900-7238.