The Vasudevan Law Office LLC - Chicago Health Care Attorney

The Vasudevan Law Office LLC - Chicago Health Care Attorney
Phone: 888-869-8834


Illinois Retrospective Insurance Audit Attorney

Chicago Lawyer Handling Insurance Audits for Doctors and Health Care Providers

After physicians treat patients, they submit claims to insurers for reimbursement under the terms of the provider agreements that they entered into with the insurers. These agreements govern the terms of the reimbursement and set the framework for how the relationship and disputes are handled. Typically, the medical coding and billing that are included in the claims submitted to the insurer are examined and evaluated, and, once approved, reimbursements are made.

With increasing frequency, however, insurers have begun to perform sophisticated algorithmic analyses on medical claims data, looking for certain red flags in the billing and coding that might indicate a false claim. A doctor who, according to the computer program's algorithms, is claiming more expensive billing and procedures than might be expected, is at risk of being subjected to a retrospective insurance audit by the insurer.

Standing Up for Doctors' Rights

At The Vasudevan Law Office LLC, we understand the challenges that doctors and other health care providers face when dealing with insurance companies and retrospective audits, and we will be an effective advocate for you interests should be the subject of one. Our firm's attorney is committed to providing tailored representation and personal attention to every client. Well-versed in all of the state and federal health care laws, Mr. Vasudevan is an honors graduate of the University of Chicago and of the University of Chicago Law School who strives to help clients understand their rights, options and obligations in every health care law matter.

If you are a doctor facing a retrospective insurance audit, take action to protect yourself. Contact our office by e-mail or by calling us at 888-869-8834.

The Retrospective Insurance Audit

When an insurance company believes that it needs to investigate further into a doctor's billing practices, it will typically send a letter or otherwise contact the doctor in order to communicate its intention to do so. The insurance company will ask to review the doctor's past claims, looking for evidence of what it believes to be incorrect or fraudulent claims. Though the insurer's manner may seem friendly, this is a very serious matter for the physician, and it should be dealt with carefully. If the insurer concludes that it has uncovered inaccurate or fraudulent claims, it may demand that the physician repay past reimbursements.

We can step in at any point when a physician has been notified that he or she is being audited. Our firm can go through the provider agreement that the doctor has with the insurer to review (and to push back, if necessary) when an insurer is entitled to perform a retrospective audit, what the insurer can ask for, and the terms of recoupment, among other issues. We aggressively work to protect the interests of the physician, who, in the absence of attorney representation, stands a significant risk of being overwhelmed.

Contact Our Illinois Office for More Information on Retrospective Insurance Audits

Contact us online or call our office at 888-869-8834 to set up a free initial consultation with our dedicated health care law lawyer. In addition to our regular business hours, we are able to meet during the evening or weekends upon request.

For the convenience of our clients, we are located in downtown Chicago on Michigan Avenue, near Millennium Park and the Art Institute of Chicago.

The Vasudevan Law Office LLC
8 South Michigan Avenue
Suite 1404
Chicago, IL 60603-3369
Phone: 888-869-8834 
Fax: 312-278-0010
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