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Stephen Bittinger

Aug 20, 2026

AlexHOST
5:59
Steven, when someone's dealing with an auditor, at what point should they consider bringing in legal counsel like yourself?
6:08
Well, so there's some real quick and easy.
6:11
There's buzzwords and acronyms, right? We work in health care, so everything's an acronym.
6:16
So the type of auditor is probably your first and easiest signal, right? So with commercial payers, it's a little more difficult because most of the audits all come from the SIU, Special Investigations Unit, or some other acronym that they allege fraud, waste, and abuse.
6:37
They'll handle both intentional-based audits, meaning they really think somebody did this on purpose, or error-based audits.
6:47
meaning they just build something wrong or a wrong frequency or a wrong unit those types of things the ones that you really got to be worried about are government payers right but there's a bunch of there's lots of different categories of government payers so for dme suppliers the number one nemesis are the upix the unified program integrity contractors for medicare or if you get an audit by a medicaid mafuku mfcu that is the medicaid fraud control unit those ones you need lawyers for because they are hunting genuine fraud and they're pretty aggressive i would say if it's not one of those primary categories most of the times if it's a commercial pair or something that looks odd bit just error based you can you can handle the production on the first round first Second major red flag of when you need counsel is if they mention anything in either the request or the original findings regarding statistical sampling and extrapolation.
7:56
So I have spent 15 years filing challenges to extrapolated overpayments.

11 MINS LATER

WayneHOST
18:34
So that

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