Medical Billing Audits & Revenue Recovery Services
Unpaid or underpaid claims can take a serious toll on your healthcare business. Whether you run a private practice or a multi-provider group, you need a system that both protects your revenue and complies with Florida and federal regulations. Our medical billing audits and revenue recovery lawyer in Palm Beach Gardens, Florida, helps clients recover owed payments and improve billing practices to reduce delays, denials, and unnecessary write-offs.
At Kopp Legal PA, we assist clients across Florida. If you have a legal concern as a healthcare practice owner or manager in Palm Beach County, Miami-Dade County, Broward County, Martin County, St. Lucie County, Collier County, or any nearby communities, our attorney is here to help. Contact our firm today to set up a time to discuss your case and options.
Why Experience Matters for Medical Billing Audits and Revenue Recovery Cases
Medical billing audits and revenue recovery involve a deep understanding of healthcare regulations, insurance contract terms, billing systems, and how claims are actually processed. Experience matters in these cases because even a small error in how claims are coded, submitted, or followed up on can lead to large financial losses. A lawyer who has seen these issues play out across different settings knows how to spot patterns, correct problems, and recover funds.
Attorney Tara Kopp’s experience working directly with providers and billing teams gives her insight into how claims break down in real life, not just in theory. She understands payer behavior, denial trends, and how to evaluate whether a claim has real recovery potential. This saves time and avoids chasing down reimbursements that are unlikely to succeed. More importantly, it helps practices strengthen their systems moving forward.
Her dual background in law and healthcare operations also allows her to bridge the gap between legal requirements and business goals. Tara is passionate about empowering her clients and helping them improve the way they manage revenue and reduce risk. That kind of dedicated guidance can make the difference between a one-time fix and lasting results.
For Experienced Legal Guidance
Our Revenue Recovery Services
Tara works with healthcare providers across Florida to recover payment for care already delivered and to prevent future losses.
Medical Revenue Recovery
Recovering revenue starts with understanding where breakdowns happen. Tara helps providers pursue past-due claims and proactively reduce billing issues by:
Addressing nonpayment from auto insurance, workers’ comp, Medicare, Medicaid, and private insurers
Reviewing claims and account histories (up to 5 years back) to identify underpayments
Taking legal action when needed through appeals, arbitration, or litigation
Creating workflows to catch billing issues before they become costly disputes
Billing Compliance Audits
Proper documentation and coding are key to getting paid—and to avoiding serious penalties. Tara provides billing audits for physicians, billing departments, and administrators to:
Confirm compliance with Florida and federal billing laws
Review CPT codes, modifiers, and payer rules
Implement updated procedures that reduce the risk of denials or clawbacks
Conduct recurring reviews to stay current with regulatory changes
Medical Billing and Recovery FAQs
What can I do if insurance isn’t paying my medical claims?
When insurers delay or deny payment, you have several options. You may be able to submit an appeal directly to the payer, initiate a peer review or reconsideration request, or use state and federal complaint processes—especially if the insurer is a commercial carrier acting in bad faith.
In Florida, providers can also file a claim with the Office of Insurance Regulation (OIR) or pursue legal action if there's evidence of systematic underpayment or contract breaches. Tara reviews billing records, appeal histories, and payer contracts to determine where the breakdown occurred and what remedies are available—whether administrative or legal.
Can I audit my practice’s old accounts for missing payments?
Yes. In Florida, most private insurance contracts have a “lookback” or recovery window of two to five years, depending on the payer and plan type. Medicare allows claims reprocessing up to one year in most cases. However, overpayments can be collected for up to five years under specific fraud investigations.
Medicaid’s limits vary depending on managed care contracts and whether the provider is appealing a denial or responding to a recovery. Tara conducts legal audits that help uncover missed billing opportunities, underpayments, and patterns of systemic payer error that may still be recoverable.
Are billing audits only for large practices?
Not at all. Smaller practices often have fewer administrative resources, which makes them more vulnerable to repeat errors and missed revenue.
A single modifier mistake, missing documentation, or misunderstanding of payer rules can affect dozens—or even hundreds—of claims. Periodic audits can catch these patterns early. Tara works with both solo providers and small group practices across Florida to help improve cash flow, reduce risk, and implement practical compliance safeguards.
What are the most common reasons for claim denials in Florida?
Common denial reasons include incorrect CPT or ICD-10 codes, missing modifiers, lack of required medical necessity documentation, duplicate claims, and untimely filing. Florida insurers may also impose state-specific requirements through their contracts with providers—such as preauthorization steps or strict appeal deadlines.
Tara identifies these issues during claim reviews and helps put procedures in place to minimize future denials. She also assists practices in drafting internal documentation policies that comply with payer and regulatory expectations.
Contact Our Healthcare Business Lawyer Today
If your practice is facing claim denials, inconsistent payments, or billing compliance concerns, don’t wait to take action. Tara Kopp provides clear, practical legal support tailored to healthcare providers and business owners across Florida. Whether you need help recovering unpaid claims, auditing past accounts, or responding to a payer audit, our firm is here to help you protect your bottom line. Contact us today to schedule a free consultation and take the first step toward stronger financial and legal footing.