Audit Recovery

We have a proven long term track record in successful audit recovery and reversal of overpayment processes with Medicare.

Our knowledge is the foundation of our continued success in recovering lost revenue. Our hard work and professionalism is exhibited in our many achievements.

This is extremely important in light of increased CERT and RAC audits, as well as prepayment review of many DME items. Professional Medical Administrators is extremely aggressive in the area of denial reversal and appeals for over 13 years for existing clients as well as on a contract basis.

We perform analyses of paid claims data and review corresponding medical records to determine medical necessity. Determination of medical necessity is based on applicable guidelines and clinical expertise.

We perform analyses of paid claims data and review corresponding medical records to determine accuracy of DRG and/or ICD-9-CM/CPT codes assigned as well as other items which may impact reimbursement.

For all healthcare payors, we analyze paid claims data to determine if the services provided are reasonable and necessary based on contractual standards.

Pro-Med is available to work with your agency as consultants in Audit Recovery. We provide technical assistance in setting up your own Audit Recovery program and/or we can perform your activities for you. Our highly qualified staff can help you determine and implement an audit recovery program for your organization.

Benefits Of Outsourcing Your Billing

There are many good reasons to outsource your billing to Pro-Med, but the biggest one is the ability to do what you do best, take care of your patients.


We work with you so you don't have to spend as much time on tedious billing, regulatory compliance, practice management, and accounting.

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