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.
As we near the end of 2024, organizations should be preparing and planning for 2025. Part of this preparation is developing a 2025 Compliance Work Plan to establish your organization’s focus areas. Your organization’s work plan should include compliance, privacy, security and may even include legal. Some of the elements may include operations, developing policies and procedures, training, and auditing and monitoring. The items included should be areas that need to be improved or developed
Just last month the Office of the Inspector General (OIG) put out an Industry Segment-Specific Compliance Program Guidance for Skilled Nursing Facilities and Nursing Facilities (Nursing Facility ICPG). Since 1998, the OIG has been issuing voluntary Compliance Program Guidance documents (CPGs) directed at various segments of the health care industry. At the center of this CPG modernization effort is the OIG’s General Compliance Program Guidance (GCPG), a reference guide for the health care compliance community
The Centers for Medicare & Medicaid Services (CMS) has been collecting feedback from healthcare providers on how to improve the Non-Therapy Ancillary (NTA) component of the Patient-Driven Payment Model (PDPM) in Skilled Nursing Facilities (SNFs). In response to concerns and data analysis from Fiscal Year (FY) 2019-2022, CMS has proposed several changes to simplify and improve how NTA points are assigned. While the NTA changes were not in effect on October 1, 2024, CMS has
“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.”
