Medicare Audit Defense
and Compliance Experts
Whether you’re facing an audit or working to prevent one, MedIntegrity Solution's former Medicare insiders are here to protect you.
WHO WE ARE
The Experts Behind the Experts.
We were inside the audit process yesterday, now protecting you from it today. Not long ago we were selecting claims, analyzing billing, and issuing denials. Now we use that same experience to defend providers and protect revenue. Our team includes former Subject Matter Experts and Project Leads from the UPIC, MAC, RAC, and OIG. That perspective turns compliance into confidence and gives your practice a decisive edge.
Who We Serve:
Providers/Practitioners
Durable Medical Equipment (DME) Suppliers
Home Health Agencies (HHA)
Attorneys
OUR SERVICES
Beyond Defense.
Toward Prevention.
From audit response to billing oversight, we cover it all.
MedIntegrity doesn’t just react to denials, we help prevent them. Our services span from pre- and post-pay denials to preauthorizations, billing and training. We deliver clarity, strategy, and protection at every stage of your Medicare revenue cycle.
PREAUTHORIZATIONS
Starting in 2026, under the new Wasteful and Inappropriate Service Reduction (WISeR) model, Medicare will require either a prior authorization or prepayment review for skin substitutes and sixteen other medical services in six pilot states: Arizona, New Jersey, Ohio, Oklahoma, Texas, and Washington. We review your documentation and prepare submissions that reflect coverage criteria, helping support favorable outcomes and minimize the risk for denials.
PREPAY DENIALS
A prepay denial happens when a MAC stops a claim or decides documentation doesn’t meet coverage requirements, delaying or denying reimbursement. We manage these denials end to end, auditing your records to show exactly what MACs need. We speak their language because we used to be them.
POST-PAY DENIALS
A post-payment audit is payment that is taken back. Often these reviews start small but can escalate into large repayment demands if not managed carefully. We defend each claim individually and challenge flawed extrapolation methods. Our insider expertise helps reduce financial exposure and protect your practice.
BILLING OVERSIGHT & SUPPORT
Billing data is the first line of audit defense, but it can also trigger reviews if it looks flawed. We analyze your billing patterns the same way contractors do, flagging risks early. We guide adjustments to keep your billing compliant and safe from audit triggers.
TRAINING & DOCUMENTATION SUPPORT
We provide live, customized training sessions using your own records. Our team teaches providers how to meet Medicare’s standards from NCDs, LCDs, and manuals. The result is stronger documentation and fewer denials.
FULL REVENUE CYCLE MANAGEMENT
From preauthorizations to post-pay audits, we manage the entire Medicare revenue cycle. Our insider knowledge closes gaps, reduces denials, and safeguards reimbursement. You get clarity, strategy, and protection at every stage.
WHY CHOOSE US
Experience That Works for You.
Proven expertise in high-risk Medicare claims.
We’ve worked inside Medicare Contractors and know their tactics. Our team specializes in high-risk areas like skin substitutes, drug denials, DME, and Home Health. That insider perspective means we don’t just advise, we equip you with strategies that work.
WHAT'S AT RISK
The True Cost of Getting It Wrong.
Audits often don’t stop at one letter, they escalate.
A single ADR can snowball into hundreds of thousands, even millions in repayment demands. Paying often doesn’t close the issue; it usually invites more scrutiny. With MedIntegrity Solutions, you mount a defense that helps stop the cycle before it grows. Delay costs money, but the right defense saves it.
CONTACT US
Received a Medicare letter or have a question about compliance?
The right response starts here.
Every audit or denial can feel overwhelming, but you don’t have to face it alone. Contact us and put former Medicare insiders on your side.