Argus West’s SIU SPEAR Program Lien Unit has achieved a significant victory by preventing any payments on $43,521.00 in billed services submitted by a chiropractic provider through bill review on multiple claims.

During the investigation by Argus West’s Provider Fraud and Abuse Unit, several critical issues were uncovered with the provider’s operations, including:

• Misuse of an EIN
• Regulatory violations
• Misrepresenting services through improper coding
• Operating in violation of California Corporations Code

Armed with this evidence, the SIU Lien Unit at Argus West effectively leveraged regulatory defenses to compel the provider to withdraw multiple liens before trial.

This success not only safeguarded a combined $43,521.00 from being paid on claims but also ensured that ZERO payments were made to this medical provider. Additionally, the matter was escalated to the Department of Insurance (DOI) and Los Angeles County District Attorney’s Office for further action.

Through the expertise and vigilance of Argus West’s SIU Lien Unit, this case exemplifies the SPEAR Program’s commitment to protecting clients by exposing abuse and fraud, enforcing compliance, and ensuring fair outcomes.

If your contract SIU is not saving you millions of dollars in Provider Fraud and Abuse investigations, coupled with an effective front end bill review integration and back end SIU focused Lien Unit, we can help.  In fact, there is no other contract SIU that is doing this other than Argus West.  Our revolutionary new program has saved over $4.2 million with a 98% lien savings success rate on hundreds of our flagged providers in just under one year!  Stop the leakage and decrease your or your clients overall combined ratio now!  Email us for more information at:info@arguswest.com