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Forensic and Dispute

Being proactive to avoid the costly reactive.

New regulations and relationships across the health care landscape have introduced increased scrutiny from regulators and other stakeholders, increased demand for transparency, increased pressure from business partners and newly expanded roles for health plans and providers.

Health plans need defense against conflict and compliance issues that can waste time, cost money and drain energy from core performance.

Any time different interests cross paths, there’s the potential for disagreement. That includes participants in the health care system—patients, plans, providers and their business partners—and it certainly includes regulatory authorities. Taking a thoughtful approach to structuring programs and relationships with potential disputes in mind, may help you experience fewer of them. Deloitte’s team of health care veterans and former prosecutors, law enforcement agents and regulators draw upon our abilities in finance, consulting, audit, analytics and other areas to help you anticipate issues before they occur as well as react when they do occur.

When disputes arise, it’s important to be informed about the issue. That requires access to secure data, along with the forensic accounting and modeling techniques that can help you understand the allegations and make your own case as strong as it can be. The same disciplines of awareness and analytics can also help keep things from getting that far. Using analytics solutions to understand data and generate insights, health plans can predict potential issues. Predicting these issues can help you to find, resolve and proactively self-report compliance violations. Potential benefits include everything from providing concise solutions to regulators to protection of management integrity and avoiding reputational risk.

Related solutions:

  • Audit and risk management
  • Forensic accounting
  • Forensic computing
  • Analytics
  • Data governance

Contact us

 Mike Little, Senior Manager, Deloitte Financial Advisory Services LLP

 

As used in this document, "Deloitte" means Deloitte LLP and its subsidiaries. Please see www.deloitte.com/us/about for a detailed description of the legal structure of Deloitte LLP and its subsidiaries. Certain services may not be available to attest clients under the rules and regulations of public accounting.

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