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Gain confidenceHealthcare compliance consulting

Comprehensive solutions for compliance obligations

The healthcare regulatory environment is ever evolving and perennially complex. Whether the client’s need is proactive or reactive, BerryDunn offers expert solutions focused on helping healthcare organizations of any type meet their compliance obligations.

Together, we assess an organization’s compliance plan and conduct a review to enhance the culture of compliance. Organizations choose us for our healthcare industry expertise, our certified healthcare compliance consultants, and for the care and attention we give that builds long-term client relationships.

From compliance plan development through evaluation of effectiveness or serving as an Independent Review Organization (IRO) for those under a Corporate Integrity Agreement (CIAs), audits, or record reviews, we establish a collaborative working relationship ensuring the result is detailed, operational, and actionable. 

We provide an objective assessment of internal processes and recommend sustainable improvements. Our services include:

  • Monitoring as an Independent Review Organization (IRO)
  • HIPAA compliance risk analysis, penetration testing, security assessments, policy review, and Business Associate Agreement (BAA) audits
  • Risk-based compliance programs
  • Credentialing, Primary Source Verification (PSV), and enrollment
  • Medicare, Medicaid, and commercial payer audits
  • Billing and revenue cycle consulting
  • Clinical documentation improvement programs
  • Coding analysis, research, and reviews
  • 340B program compliance 

BerryDunn has joined forces with the VantagePoint Healthcare Compliance and Credentialing team to expand the services we provide to healthcare organizations. Contact us to learn more about our healthcare compliance services.

Independent Review Organization (IRO) services
Healthcare organizations entering into Corporate Integrity Agreements (CIA) with the HHS OIG are often required to engage an IRO. BerryDunn is an experienced IRO, serving in this role for a diverse array of healthcare provider types, including behavioral health, substance use disorder treatment providers, home health, hospital, DME suppliers, laboratories, and independent physicians.

We utilize the OIG-approved RAT-STATS statistical sampling software, have in-house expertise to conduct audits per CIA Appendix specifications, and provide well-written reports that meet the OIG expectations. Beyond satisfying the specific requirements of the CIA, a qualified and independent entity such as BerryDunn can provide an objective assessment of internal processes and actionable recommendations for improvement as part of an annual or quarterly claims or arrangement review report requirement.

Compliance program effectiveness assessment
BerryDunn’s compliance program effectiveness assessments are differentiated by our collaborative approach. Our healthcare consultants work with both compliance and operational leadership to perform an independent assessment against the seven elements of an effective program, as published by the OIG. We examine program design, operational applications, and whether a program (as documented) actually works in practice. Our compliance effectiveness assessments include comprehensive documentation review, on-site verification and interviews, a formal final report including an executive summary, detailed findings and observations, and an operational action plan. Implementation support is an optional and popular add-on service.

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