Use of statistical sampling and extrapolation in overpayment audits of physicians.
The successful defense of claims for physician overpayments by insurers requires the health care attorney to be familiar with the statistical sampling procedures employed during these types of audits. In this article, the author describes when audits are initiated, the factors that are taken into account in determining if statistical sampling is appropriate, how the statistical sampling study is conducted, and what defenses the health care attorney can assert when confronted with the results of a statistical sampling audit.
Shaw
P W
PW
D007345:Insurance Claim Review / Q000592:standards*; D007349:Insurance, Health, Reimbursement / Q000331:legislation & jurisprudence*; D016345:Medicare Part B / Q000592:standards*; D012494:Sampling Studies; D014481:United States