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.

Independent Review Organization (IRO)

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.

Latest Posts

In nursing home settings, ensuring medically necessary visits by physicians or Qualified Healthcare Professionals (QHPs) is critical for providing high-quality care and maintaining compliance with Medicare guidelines. This whitepaper outlines the definition of medical necessity, Medicare’s guidance on billing and documentation, and key considerations for determining the necessity of patient visits. Definition of Medical Necessity Medicare defines medical necessity as: “Services or items reasonable and necessary for the diagnosis or treatment of illness or injury
LW Consulting, Inc. (LWCI) had the pleasure of attending the 2025 LeadingAge PA Annual Conference & Expo. This year’s theme was IMPACT – the impact that we have on our peers and the future of aging services. The conference kicked off with an incredible keynote by Ryan Leak on his book “Leveling Up: 7 Questions for Next-Level Leadership.” He discussed identifying personal success and the questions that you need to ask yourself to “level up.”
Significant developments have occurred since the March 2025 blog on “The Hertel & Brown Case: Harsh Reminders for Therapy Clinics.” The federal case against Hertel & Brown Physical and Aquatic Therapy has reached a turning point. With guilty pleas from the owners and sentencing dates approaching, this case is no longer just about uncovering fraud; it is about what the fallout means for outpatient therapy clinics across the country. Key Developments Guilty Pleas from Leadership

What Our Clients Are Saying

Gwinnett Christian Terrace

“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.”

Alan Plotkin, CEO