I received a UPIC audit in the mail today for grafts I provided a year ago. They want a lot of money back. I know I documented well, can you suggest or advise what my steps are in appealing this 100% denial?
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When you receive a UPIC (Unified Program Integrity Contractor) audit, CMS (Centers for Medicare & Medicaid Services have intensified their efforts to identify organizations with improper billing practices, so they feel you are not billing properly. The UPIC contracts operate in five (5) separate geographical jurisdictions in the United States and should identify who they are, you should seek a healthcare attorney on your own with experience in UPIC's and/or your administrative defense fund advisors before you proceed. You usually are given 15 days from the date the letter is written, if you plan on appealing, make sure you timely notify in writing the UPIC that you are appealing their findings. Get a confirmation they received your request to appeal their determination.