Barraclough's proprietary time-tested litigation strategies allow for the methodical examination of the evidence. We may invalidate critical steps taken by the auditor.
The Medicare Program Integrity Manual (MPIM) Section 8.4.3 emphasizes that a valid statistical methodology should be used and specifies a number of factors including a) the universe was properly defined; b) the frame was properly defined; and several others.
Barraclough checks the Recovery Audit Contractor's statistical work against all of these factors.
Strategy 3 – "Properly Executed" Statistical Methodology
Is the work by the Recovery Audit Contractor in compliance with all statutory requirements?
Barraclough does a thorough check to find any discrepancies.
Strategy 1 – Statutory Compliance
Statistical Extrapolations made by a Recovery Audit Contractor (RAC) during a Medicaid Audit or Medicare Audit are based on a foundation of mathematics.
Barraclough offers more than three dozen tests to determine if the Extrapolation is accurate.
Strategy 2 – Mathematical Validity
Both the Medicare Program Integrity Manual (MPIM) as well as the governing Medicaid laws in individual states specifiy that the Audit Contractor must maintain complete documentation of their statistical work.
Barraclough checks the work of the Recovery Audit Contractor to ensure that all documentation requirements are met.
Do you want to win your Medicare or Medicaid Appeal? Do you have any questions on how to get started with this process? Then we want to talk with you. Please use the Contact form and let us help you win.
Strategy 4 – Sufficient Documentation Requirements
Strategy 5 – Daubert Credibility
All statistical sampling and extrapolation work performed by the Recovery Audit Contractor must be validated by a statistician with Scientific Credibility.
Barraclough carefully examines and validates how the statistical methodology was created, who created it, and whether or not scientifically acceptable techniques were used.