"Integrity, professionalism and experience are essential in investigations and consulting services. We provide our clients discreet and timely results within this framework."

Jack Sandlin & Associates
Indianapolis IN
317-791-1349
800-794-3880
PI Lic#: PI20700112

A Veteran Owned Business (VBE)

Medical Overpayment Recovery Services:

Coding and billing services actively solicit business from the medical community with promises of substantial increases in revenue. If only a few services consciously engage in fraudulent activity, the net effect is to increase employer claims costs an average of three to ten percent. Workers' compensation claims fraud is twice as high. We have found these results are typical even after claims have been reviewed and paid by a TPA or insurance company.

We employ the latest forensic claims auditing to identify your overpayments to medical providers, and we recover those funds for you. We use official American Medical Association and American Hospital Association code sets as mandated by HIPAA governmental regulations. Our proprietary approach essentially "reverse engineered" the process used by coding and billing practitioners. By using an organization supervised by Certified Fraud Examiners, you may be confident that the process will be documented, ethical and professional.

Allow us to perform (free of charge) a retrospective analysis of your actual claims to identify specific overpayments made by your TPA or insurance company. You will be provided with a detailed report listing the provider names, amounts of overpayments, and the reason for overpayment.

Typical reasons for claims overpayments are:

• The invoice is inconsistent with the medical provider's records.
• The diagnosis is inconsistent with the procedure.
• The procedure was unbundled.
• The information submitted does not support the number of services.
• The procedure code is inconsistent with the clinical circumstance.
• Lack of medical necessity.
• The procedure was inconsistent with the patient's age or gender.

Contact Greg Wright direct at (317) 908-4899 for more information or by email at .