DME Audits, UPICs, Extrapolation, and AI: Legal Insights with Stephen Bittinger
On the Claim to Fame DME podcast, healthcare attorney Stephen Bittinger of Polsinelli explains how he defends providers against payer audits and sues payers for unpaid or denied claims. He says DME suppliers are frequent audit targets due to complex, changing rules, often identified through payer data mining or watch lists. Common provider mistakes include poor document production; he advises making records organized, chronological, and easy for auditors. He recommends legal counsel especially for UPIC or Medicaid MFCU audits and whenever statistical sampling and extrapolation is involved…
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