Professional Healthcare Consulting
National healthcare professionals with more than 200 years of combined experience
As healthcare continues to evolve, so does the depth and breadth of the consulting services we provide. B. Riley's Healthcare Advisory Services encompass a range of service areas spanning the healthcare continuum and fundamentals of the healthcare business.
Whether your organization seeks to improve operating performance, maintain compliance, strategically plan for the future or resolve a dispute, our comprehensive approach and deep industry experience ensures seamless solutions and proven results.
Our expertise is surpassed only by our commitment to consistently deliver the three elements we believe serve as the foundation for any successful consulting relationship: Experience. Integrity. Results.
Join the hundreds of healthcare providers, health plans, institutions, law firms and other healthcare or related businesses that turn to B. Riley for candid advice and measurable results.
SOLUTIONS & RESOURCES
Professional Healthcare Consulting Capabilities
Compliance & Internal Audit
The healthcare industry faces unprecedented pressures to continuously improve the quality of its services, procedures and operations, all while reducing cost and overall operating and capital budgets. Navigating through the expectations of consumers, regulators, payors, employees and governance requires an effective risk management strategy that includes a robust internal audit function.
B. Riley's healthcare compliance and internal audit services offer a holistic approach that leverages standards-based methodologies to assess and analyze organizational business process impacts, compliance adherence and internal control risks for the following areas:
- Compliance audits to meet regulatory and accreditation standards
- Operational audits to improve effectiveness and efficiency of operations
- Financial audits to increase reporting reliability
- Healthcare IT audits
- Litigation-related audits, investigational or other situation-specific audits
- Post-audit remediation - policies, procedures, templates, tools, technology solutions, and oversight reporting to senior management and governance
- Enterprise-wide risk assessment, internal audit and compliance work plan development
- Interim management and compliance officer services
- Audits of mature corporate and departmental compliance programs efficiency and effectiveness
- Audits of documentation, charge capture, coding and billing processes and systems
- Design and implementation of compliance program and monitoring processes
- Develop compliance standards, policies of conduct and procedures by collaborating with the client to meet their unique needs and obligations
- HIPAA / HITECH privacy and security assessment and implementation
- Innovative and effective compliance workforce training
- Support for organizations or individuals facing investigation, administrative or other sanctions by regulatory or law enforcement agencies
- Function as an Independent Review Organization (IRO) on behalf of organizations operating under a Corporate Integrity Agreement (CIA)
- Special compliance for due diligence in joint ventures, and mergers and acquisitions
- Internal audit consultants in a partially or fully outsourced or co-sourced model for hospitals, health systems, academic medical centers, medical groups, durable medical equipment suppliers, clinical laboratories, and Medicare Advantage sponsors
Revenue Cycle & EHR Optimization
Our B. Riley's Healthcare revenue cycle management optimization approach leverages our team's years of hands on experience with many of the nation's leading healthcare systems and government programs. Our best practice, standards-based revenue cycle improvement programs and EHR business integration solutions yield predictable ROIs along with sustainable results. Working with your operational and technology capabilities, our team partners with your organization to manage, automate and optimize revenue generation, charge capture, and payment and claims processing throughout your clinical workflow and business office operations.
In an environment of ever-changing reimbursement methodologies, regulated relationships and growing costs, the focus on revenue capture, processes efficiencies and regulatory compliance is critical. B. Riley has the expertise, capability and resources to provide you with a complete set of patient, provider and health plan solutions that can directly:
- Ensure appropriate reimbursement for healthcare organizations
- Identify and implement best practice compliance and data security standards
- Reduce administrative burden and lower costs
- Identify, mitigate or remediate regulatory compliance, financial and reputational risk
Coding & Reimbursement
From DRGs to CPTs, the healthcare industry relies on coding and other reimbursement methodologies for crucial data gathering, payment and compliance. At B. Riley, we understand the practice and business of medicine can be paralyzed without complete, compliant, accurate and current coding and reimbursement knowledge.
Our Healthcare Advisory Services team specializes in providing coding consulting, auditing, operational support and training to our clients to evaluate and improve their financial performance, streamline operations and meet regulatory requirements.
- Coding consulting, audit assistance and program development for Federal, State and Commercial reimbursement programs
- Coding compliance, documentation and reimbursement audits
- Coding education, training and mentoring programs
- Charge Description Master (CDM) and charge capture optimization
- Clinical Documentation Improvement (CDI) programs and implementation assistance
- Computer Assisted Coding (CAC) planning and implementation
- Interim HIM and coding management services
- HIM consulting for operations assessment, workflow analysis and special projects
- Temporary and outsourced coding services, including full remote coding operations
Healthcare Information Technology - Forensics & Security
Our B. Riley's healthcare technology team can help you protect patient health information, and provide assistance if an adverse event takes place within your information systems including data forensics and retrieval.
Our team is passionate about helping you navigate the evolving compliance and technology landscape. Our dedicated health care professionals have extensive regulatory compliance, data forensics, and system security experience to help you develop a comprehensive cybersecurity program or identify opportunities to optimize your current security model. From policy development to incident response, we will help you achieve compliance with federal regulations, defend your IT systems, and protect your financial assets against outside interests.
Our approach is based on guidance from the National Institute of Standards and Technology (NIST) and is HIPAA and HITECH compliant to provide you with relevant, accurate, and timely assistance. Our years of experience and relationships with a vast network of health care organizations across the country provides our clients with real-world insights and experience which leads to pragmatic solutions and confident decisions.
- HIPAA / HITECH risk assessments and remediation services
- HITRUST validated Common Security Framework (CSF) assessments and remediation services
- PCI compliance assessments and remediation services
- Vulnerability assessments and gap analysis
- Penetration testing
- Computer forensics and Cybersecurity incident response services
- Privacy and security training
- Business continuity and disaster recovery planning
- HIM consulting for operations assessment, workflow analysis and special projects
Today's evolving and increasingly complex healthcare marketplace consistently presents new challenges for healthcare organizations and investors alike. At B. Riley, our deep industry experience and analytical resources can lead to real problem solving for the broad range of issues our clients face.
Whether evaluating new or existing service lines or seeking data and analysis to determine the quality of an investment opportunity or pricing strategy, today's healthcare and financial organizations rely on strategic analytics to empower key business decisions. Our consultants design solutions and produce analyses that not only provide this information, but interpret it in a way that makes it relevant to each organization's unique goals, challenges and decision-making.
B. Riley has the ability to consume large sets of structured and unstructured data and leverage proprietary data models and toolsets to address a wide range of analyses and problem-solving assignments including focus areas such as pricing, managed care contracting, claims payment disputes, litigation support, due-diligence investigations, and strategic decision-making.
- Market and financial forecasting
- ROI analysis
- Regulatory impact analysis
- Risk assessment
- Reimbursement analysis - contract modeling (fee-for-service), value-based care (including risk adjustment analysis), pay for performance (incentive-based programs), quality programs (HEDIS/STAR)
- Payor/provider data correlation
- Government payer analysis
- Ad hoc complex data analytics