healthcare payer strategy consulting




Disputes & Forensics Solutions for Payers

We provide information analytics, forensic accounting, and expert testimony skills to help companies and their counsel quantify the potential impact of issues arising in the course of a dispute.

We have worked with all types of payer entities including commercial, government, third-party administrators and pharmacy benefit managers and has been deeply involved with all major and high profile issues facing these payers over the past few decades. Our services include:

  • Consulting and Expert Witness Services
  • Class Certification Defense
  • Out-of-Network/UCR Disputes
  • Payment Disputes, including Risk Adjustment payment models
  • Federal and State Investigations
  • False Claims and Qui Tam Matters
  • Post-Acquisition Purchase Price Disputes
  • Narrow Network Disputes
  • Medical, Pharmacy and Behavioral Health Payment and Coverage Disputes

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