Audits, Appeals & Legal Assistance

Four Seasons Consulting Group has the level of expertise to provide assistance with Additional Developmental Requests (ADRs) up to full legal reviews with expert testimony on cases involving the Department of Justice. Examining risk areas to help mitigate audits around eligibility issues and technical denials is a competency our team is equipped to handle.

• Independent chart reviews
• Identify risk areas of concern
• Mentor proactive improvements to processes related to key risk areas
• Education to leadership and staff
• Develop process for responding to ADRs
• Assistance with improving processes in response to audits
• Assistance with the appeals process
• Physician representation at ALJ and MIC Audit
• Legal reviews (for MIC, ZPIC, DOJ cases)
• Physician and expert testimony

Audits, Appeals & Legal Assistance Team

FSCG under the leadership of Janet Bull, contracts with over 12 qualified physician and nurse reviewers across the country to provide legal reviews to a host of programs across the country. Other key personnel in this area include our compliance team.