You wouldn’t look at just one body part before giving your patient a diagnosis so why choose a healthcare consultant that only understands one area of your operations? Our AHIMA and AAPC credentialed team understands the complex interplay between quality of care and improvements in clinical documentation, coding, and billing. We’ll find any areas that could be improved and work with you to develop and implement best practices, not just for compliance but for optimum revenue and efficiency.

Compliance Consulting

Our compliance consultants look at a client’s entire system, including processes, documentation and operations, to identify and correct potential problems. Our experience includes:

  • Advising on Medicare, Medicaid, and Tricare reimbursement regulations, documentation, coding and payment requirements
  • Drafting policies and procedures that help clients implement and adapt to new billing requirements
  • Sharing our in-depth knowledge of all regulatory and coding guidelines that affect revenue cycle
  • Examining a client’s entire billing cycle to fix problems with documentation, entry, coding and claims, including an in-depth Chargemaster (CDM) review
  • Training billing staff on best practices and creating the correct educational materials to support the client’s ongoing compliance efforts

Healthcare Auditing

A healthcare provider’s best chance at achieving operational success is to be as proactive as possible. That’s where experienced auditors and clinicians come in to play. Our healthcare auditing experience includes:

  • Performed over 10,000 educational audits for physicians, nurses, coders and ancillary staff
  • Working with OIG protocol for defensive audits and other government audit entities (e.g. RAC, MAC, CERT, MIC, MIP, RADV and ZPIC)
  • Working with clinical department leaders on CDM reviews for multi-hospital systems, large institutions, and critical access hospitals
  • Advising on compliance issues related to ICD10-CM and CPT coding guidelines and performing repayment audits

Members of our Healthcare and Audit Compliance Team come from all areas of the healthcare sector and many have worked as auditors for more than 25 years so we understand the industry and its challenges. Our analysis occurs within a law firm to ensure findings are protected while appropriate responses are developed.

Our team is supported by veteran healthcare attorneys with experience in the areas of:

  • Major transactions for healthcare providers (i.e., mergers & acquisitions)
  • Regulatory issues
  • Healthcare litigation
  • Employment law
  • Healthcare bankruptcy
  • Day-to-day operations
    Key Contacts