Medicare Compliance Practice

Quintairos, Prieto, Wood & Boyer, P.A.’s Dedicated Medicare Compliance Group works nationally with self-insured entities, and carriers in no-fault, workers’ compensation and other liability actions to ensure compliance with Medicare’s statutes and regulations.   As a “best practice,” we strongly recommend considering the potential interests of Medicare immediately upon receipt of a claim and ongoing as it progresses.

We perform everything ― from investigating and negotiating conditional payments through the submission and funding for potential future medical expenses.  At QPWB, we understand the individual nature of each client and claim and employ a unique and comprehensive approach to provide the correct solution every time.

  • We address each claim on its own merits and not in a cookie cutter manner.
  • As attorneys, we act as advocates on behalf of our clients focusing on every factual, legal and medical argument to help develop strategies to reduce exposure.

We make realistic recommendations in order that clients can make informed decisions and work towards understanding and resolving compliance issues in the most economical fashion.  The firm provides attorneys with decades of experience in counseling self-insured and insurance clients, as well as, meeting with opposing parties and attending Administrative and Judicial pre-trials to address compliance issues.  We provide individualized attention to the needs of our clients, from the very smallest matter to the very largest.

In situations where QPWB is not handling the underlying claim directly, we still work with outside vendors and attorneys to address primary payer issues, modify cost projections, make factual, legal and medical arguments for “zero” set-asides, and help prepare settlement documents.

We perform services at a reasonable / competitive rate and they include but are not limited to:

  • Litigation consultation to help reduce exposure
  • Social Security verification
  • Conditional payment investigation and negotiation
  • Medicare Advantage Plan (MAP) lien verification and negotiation
  • Preparation of cost projections
  • Submissions for future medical expenses
  • Pre-submission review of other vendor documentation
  • Settlement Contract/Release preparation
  • Post-settlement management of Medicare related issues
  • Evaluation of unfavorable responses from Medicare

We provide educational seminars and presentations that you feel might be useful to your organization.

Print Friendly