health provider consulting




Government investigations, contractual disputes, allegations of fraud and mismanagement, and complex litigation matters are disruptive to the business activities of a health care organization and can have a significant impact on resources and finances. To manage these risks, healthcare organizations need a partner with in-depth knowledge of the health care industry and its regulations Guidehouse brings a combination of clinical, coding, and reimbursement professionals, along with our team of economists, forensic accountants and data analysts each with specific experience supporting providers and their Counsel with issues raised in today’s litigation environment. Our services include:

  • False Claims Act, Anti-Kickback Statute, and Stark Law investigation support
  • Clinical documentation and billing compliance and investigations
  • Evaluation of medical necessity and levels of care
  • Clinical research and grant funding investigations
  • Data analytics and statistical sampling
  • Financial damages analyses
  • Data breach investigation and response
  • Defense support in government safeguard contractor (RAC, ZPIC, etc.) audits
  • Expert testimony


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