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We talk with healthcare attorney Matt Stevens about the real-world legal and operational fights clinics face with insurance reimbursement, audits, and payer clawbacks, plus the steps that keep small problems from turning into career-level crises. We also get practical about employment disputes and why strong systems, especially timekeeping, reduce wage and hour exposure even when people act unpredictably.

• what Provider Legal does for healthcare providers as outside general counsel and transaction support
• why insurance reimbursement creates conflict and how payer incentives shape denials and delays
• how to handle SIU inquiries and recoupment demands without overreacting
• common triggers for payer scrutiny including incident-to billing documentation and unusual coding patterns
• strategies to pursue underpayments without jumping into litigation, including escalation tactics
• why employee billing concerns can escalate into qui tam risk and government investigations
• early moves that lower exposure, including compliance plans and third-party billing reviews
• where employment disputes show up most often and how plaintiff firms approach staff claims
• wage and hour vulnerabilities driven by timekeeping records, breaks, and documentation
• accepting that you cannot eliminate claims, only reduce frequency and cost

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This episode is brought to you by Seasoned Advice HR, where I help eye care clinics to hire, retain, and manage better — helping you get Better Results Through People. Learn more at seasoned-advice.com.

Contact me directly at mike@seasoned-advice.com

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