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

Concurrent Therapy Group
In Part 2 of this two-part blog series “Group vs. Concurrent Therapy: Are You Documenting Accurately?” we will discuss actual documentation of examples that may not support group and concurrent therapy as skilled and reasonable. In Part 1, we reviewed the definitions of group and concurrent therapy. Both definitions can be found in the Resident Assessment Instrument (RAI) Manual, Pages O-23-O-25. To refresh your memory, the Centers for Medicare & Medicaid Services (CMS) currently defines
Concurrent Therapy Group
Since October 1, 2019, for Medicare A recipients, the Resource Utilization Groups (RUGS) IV is out and the Patient Driven Payment Model (PDPM) is in. The first two years of the transition were complicated by COVID and the PHE. But since May 2023 when the PHE ended, things have been getting back to normal. It is important to remember that although the reimbursement model has changed, the regulations outlined in the Centers for Medicare &
Special Focus Facility Target
It is challenging being a Skilled Nursing Facility (SNF) in 2024! Not that it has ever been easy, but there are so many regulations, and the increased challenges of staffing and infection control since COVID and the PHE have really raised the bar. The Centers for Medicare & Medicaid Services (CMS) monitors quality issues and has devised a terminology for those facilities deemed high risk with a history of serious quality issues. These facilities are

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