Just wrapped up the biggest single-facility recovery of my career — $287,412 refund for a 220-bed skilled nursing facility. Root cause: facility was on a general service commercial rate, but state tariff had a dedicated healthcare rate class that they qualified for under the 2021 rate case. Utility had never reclassified them even though the facility's SIC code was on file. 4 years of overbilling. Takes about 10 months from claim submission to refund check.
Recovered $287K on a nursing home — the story
Outstanding work. This is exactly why rate-class audits should be first thing we check on every healthcare account. SIC code mismatches are the single most profitable finding in the industry and most auditors miss them.
Congrats Kevin. What was the contingency structure on a recovery that size? Did the client push back on the fee when the number came in that high?
Amazing. Can you share which state — healthcare rate class availability varies a lot. Would be great to know where to look.