Marwood's Clinical Quality & Compliance team is comprised of clinicians, former healthcare operators and certified coding experts who have deep experience across multiple sectors of healthcare and have worked with many organizations to achieve demonstrable improvement.
Clinical Quality & Compliance Assessments:
We provide investors with an assessment of a potential investment’s culture of compliance, adherence to government rules and billing accuracy and benchmark the company with its peers.
Our proprietary process has been honed through a decade of diligence work to ensure our clients receive an accurate, timely assessment of a company’s clinical processes and coding accuracy as well as the risk of financial recoupment in the event of an audit.
Clinical Quality & Compliance Consulting:
We work with healthcare operators to identify areas for improvement in their compliance process and assist them in developing a plan to achieve best practices.
Our senior clinical team helps company management develop and implement compliance plans, quality plans, employee policies and procedures, and HIPAA processes and install a process for ongoing monitoring. In addition, our team works with the management of companies under a Corporate Integrity Agreement to ensure compliance with their obligations.
RCM Functionality Assessments:
In addition to clinical quality and compliance diligence assessments, we provide investors with outlook for a potential investment’s overall Revenue Cycle Management functionality through assessment of key processes and capabilities.
Our proprietary process has been honed through a decade of diligence work and extensive experience with RCM operational dynamics across the spectrum of provider types, laboratories, and healthcare corporations providing reimbursed services.
See how Marwood assessed the clinical compliance practices of a podiatry services provider for a private equity firm looking to acquire the practice…
Marwood Case Study
Engagement Purpose
A private equity firm sought to evaluate the compliance policies and practices of two potential investments in podiatry physician practices that serve the commercial and government pay populations.
Marwood Analysis
- Assessed the target company’s compliance program and policies
- Performed a review of 100 clinical records to assess medical necessity, billing and coding practices
- Benchmarked the company’s clinical compliance performance against peers
- Evaluated management and operational team’s oversight of its compliance program and adherence to the seven OIG core elements
Key Findings
Marwood found that the target company’s compliance program, clinical charts and HIPAA policies were in need of improvement; thus, the Company is at moderate to high risk of repayment or recoupment in the event of payor scrutiny. There were numerous errors in the company’s E&M coding and DME documentation. Marwood provided specific recommendations to the Client.
