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Billing + Collections + Compliance + Audits

How To Protect Your Out-of-Network Practice from Insurer Audits

Avoid the Pitfalls by Applying Our Pre-Service Disclosure Checklist

...truly the best appeals specialists
that I have ever encountered in the industry...

~ Long Island Eye Surgical Centers

...have been the key to
fighting my appeals when these cases were going nowhere...

~ Dimitri Koumanis, MD

...are, without question, the
foremost insurance appeals authority in the industry...

~ Medicomp, Inc.

Fraud Investigations are increasing from both governmental agencies and insurance special investigation units. 

Medical providers need to use best practices to avoid even the appearance of fraud. 

Once suspected, fraud allegations can put your practice on the radar for years and can be difficult to resolve or lead to large recriminations, fines, and even license revocation or suspension. 

This likely could result in significant lost revenue and even bankruptcy. 

Download our Action Plan to learn how to protect your Out-of-Network practice from Insurer audits.

Meet The Author

Thomas J. Force, Esq. is a nationally recognized expert and frequent speaker on managed care issues, managed care contracting, managed care appeals, ERISA and out-of-network reimbursement issues. He has been a licensed attorney since 1994 in both state and federal courts in New Jersey and New York, with 27 years of experience in the healthcare and insurance industries.

He is the president and founder of The Patriot Group, a full-service healthcare physician advocacy and revenue recovery company providing billing, appeals, collections and follow-up services for healthcare. Thomas is also the former CEO, general counsel and chief compliance officer of a small New York-domiciled health insurer, a former chief operating officer, general counsel and chief compliance officer of a large East Coast billing, collections and healthcare consulting company, and a former co-chair of the Health & Hospital Law Committee of the Suffolk County Bar Association. 

Thomas recently presented on ERISA-related issues to the American College of Osteopathic Surgeons in Las Vegas and to the Medical Society of New Jersey.