Summary

audit, compliance, investigation, data analysis, complaint intake, risk assessments, performance audits, health care fraud waste and abuse, risk mitigation, quantitative and qualitative data analysis, managed care, pharmacy claims, prescription drug plans, federal health care programs, Medicare, Medicaid, Tricare, pharmacy operations, Part C, Part D, MEDIC, UPIC, medical review, prescription drug monitoring

Description

Federal and state law enforcement professionals with expertise conducting proactive and reactive criminal, civil, and internal investigations to address regulatory requirements, fraud, waste, and abuse, and misconduct. • Services yielded high returns on investment to CMS, federal government law enforcement, and regulatory agencies. • Experts in root cause analysis and driving solutions to resolve and mitigate weaknesses. • Extensive professional experience in auditing and analyzing data and information to detect and prevent fraud, waste, and abuse in commercial and federal programs and generating investigative leads for regulatory oversight organizations. • In the healthcare industry, we are experts in the areas of agent/broker practices, compliance programs, federal healthcare programs, the pharmaceutical industry, and pharmacy operations.

Profile

  • Incorporated in
    Massachusetts
  • Established since
    2013
  • Main/Branch
    Branch

Address