A wholly-owned subsidiary of Quality Health Strategies
Health Integrity, LLC, is dedicated to protecting the fiscal and clinical integrity of health care systems in Medicare, Medicaid, and the private sector.
Our experienced team of health data analysts, investigators, auditors, experienced nurses, PhD statisticians, and health information professionals has helped to set the national standard for monitoring and investigating reports of potential fraud, waste, and abuse.
What We Can Do For You
- Innovative predictive modeling and data analytics solutions
- Identify potential improper payments or fraud patterns through interactive analysis of claims
- Provide full incoming and outgoing bi-lingual call center activities for tracking, trending, and investigating issues.
- Conduct on-site audits of health care providers—target billing, quality of care, and benefit integrity
- Conduct medical record analysis to determine whether appropriate payment was made
- Develop high-quality fraud case referrals for law enforcement
- Testify in trials providing health care policy expertise
- Provide comprehensive reviews of organizations’ compliance to government program requirements
- Identify appropriate corrective actions for clients to implement
Our Areas of Expertise
- Predictive Modeling and Data Analytics
- Medical Review and Analysis
- Benefit Integrity Investigation
- Billing and Coding Audits
- Compliance Audits
- Expert Testimony
- Data Management and Information Technology
- National Healthcare Subject Matter Experts
- HIPAA Compliant with robust Data Management and Data Centers