LW Consulting, Inc. (LWCI) is a recognized leader in providing compliance, reimbursement, operational, and clinical consulting solutions across the full continuum of healthcare delivery.
We are an Independent Review Organization (IRO), performing audits under Corporate Integrity Agreements (CIA), and an expert resource to providers, attorneys, and government agencies in ensuring organizations meet the myriad of guidelines, requirements, and statutes that regulate the delivery of healthcare services. We also provide interim staffing for post-acute care providers.
Today’s compliance and risk management challenges require innovative solutions.
LWCI has the expertise and experience to achieve them.
Suite of Services
Our team includes compliance professionals, reimbursement experts, RNs, therapists, auditor-coders, and consulting physicians. Many team members possess numerous industry certifications.
Our clients receive peace of mind knowing that they have received reliable advice and guidance that improves their business.
We often work with attorneys for providers in negotiating with the MACs, the OIG, federal prosecutors, US Attorneys and State Agencies in evaluating medical necessity, coding and billing procedures, and negotiating the adjudication of potential overpayment, denials, and disputed claims.
LW Consulting, Inc. uniquely blends its comprehensive knowledge of the healthcare industry with a proven ability to work as a partner with healthcare attorneys. We understand the ebb and flow of the legal process. We are flexible, responsive, and complete our work when and where it is needed.
LW Consulting, Inc. (LWCI) had the pleasure of attending the LeadingAge PA Fall Finance Conference a couple of weeks ago. The conference had many presentations on topics that ranged from using Key Performance Indicators (KPIs) and Metrics to improve your organization’s financials to compliance and risk management. Many of the presentations appeared to have some common themes. A few of the presentations covered the use of data and other information that organizations have readily available
Many, if not most, healthcare provider compliance programs identify overpayment from Federal Payers – particularly Medicare and Medicaid – as a key risk. Whistleblowers frequently initiate government scrutiny related to Federal payors. As a result, many compliance programs focus on the Federal piece of their payor mix. Providers that do not enroll with Federal payors or for whom Federal payors are a small portion of their payer mix may have chosen to commit fewer resources
Does your organization have an annual process to review the Open PaymentTM Database? The Open PaymentTM Database was created to promote transparency and accountability in the healthcare system and is managed by the Centers for Medicare & Medicaid Services (CMS). The database houses physician payments reported by Reported Entities such as drug and medical companies. These payments are reported annually and are broken down by “Nature of Payments” including food and drink, education, and consulting
“The manner in which LW Consulting conducted our organization’s board retreat this past January, was both professional and personal. All participants were energized and inspired. As a result, during the board meeting that followed in March, every member was empowered to speak on the issues at hand. For the first time, we had generative discussions that moved the ball forward with action steps assigned to individuals or groups. Absolutely ground-breaking for our organization and we continue to reap the benefits.”
Dana Chandler
Ensign Services
“As we began the process of selecting our IRO, we wanted to engage a company that had an auditing team with real world experience. We wanted accurate and trustworthy results that could add value to our rehabilitation, nursing and MDS programs. We have found that with LW Consulting. The LW team is professional, seasoned, and experienced. The therapists and nurses evaluating our teams and documentation understand the skilled nursing and therapy world. Many of them continue to work as on-call therapists. Their guidance and evaluation skills are founded in the real world of caring for our senior population. Our staff find the LW team to be genuine, knowledgeable, respectable and approachable. Once our IRO relationship ends with LW Consulting, we hope that we will be able to continue to utilize them in a consulting capacity for many years to come.”
Deborah M. Miller RN, JD Chief Compliance & Privacy Officer
Urology Care Alliance
“We have used the services of LW Consulting for the last three years for chart review audits and follow-up training of our 25 physicians. We are extremely pleased with thoroughness and quality of the work that they have done. They have provided both individual feed-back sessions with some of our physicians as well as webinar review and training sessions that all of our physicians attended.”
