Investigation & Litigation Support
Altegra Health has extensive background working alongside attorneys representing a broad range of healthcare entities. Our clients include health systems, hospitals, clinics, pharmacies, durable medical equipment providers, clinical laboratories and payers among others. From initial investigation and discovery through expert witness testimony, we are confident that we have the competitive advantage in this regard as we have the right staff, experience, tools and processes required to meet and exceed all of your expectations. These areas are some of the core strengths upon which we have built our national reputation over the past 20+ years.
What differentiates Altegra from other consulting firms:
Our leadership team and our consultants have demonstrated success with executing auditing, monitoring, compliance and quality control processes within healthcare organizations that have successfully stood the rigorous tests of the Office of the Inspector General and the Department of Health and Human Services.
Our team credentials and certifications include, among others:
- Business Valuation (ABV)
- Coding Specialist (CCS)
- Coding Specialist - Physician Based (CCS-P)
- Controls Self-Assessment (CCSA)
- Financial Forensics (CFF)
- Healthcare Compliance (CHC)
- Healthcare Privacy Compliance (CHPC)
- Internal Audit (CIA)
- Internal Controls Auditor (CICA)
- Information Systems Auditor (CISA)
- Network Engineer (CNE)
- Paralegal (CP)
- Professional Coder (CPC)
- Public Accountant (CPA)
- Chartered Global Management Accountant (CGMA)
- Master of Business Administration (MBA)
- Microsoft Certified Professional (MCP)
- Registered Health Information Technician (RHIT)
- Registered Nurse (RN)
Agreement & Review Services
Deferred Prosecution Agreement
Corporate Integrity Agreement
Independent Review Organization Services
For over 20 years, Altegra Health has been working alongside legal counsel providing assistance related to negotiation, implementation and management of Deferred Prosecution Agreement (DPA), Corporate Integrity Agreement (CIA) and Independent Review Organization (IRO) services. Our clients include health systems, hospitals, clinics, pharmacies, durable medical equipment providers, clinical laboratories and payers among others.
The Altegra team:
- Has cultivated an approach rooted in partnership with our DPA/CIA/IRO clients, resulting in experiential learning and understanding for all participants of both the process and the rigid requirements set forth under each agreement.
- Has demonstrated success executing auditing, monitoring, and quality control processes within operations and technology support functions. These processes have successfully stood the rigorous tests of the Office of Inspector General and the Department of Health and Human Services.
- Has extensive front-line revenue cycle, compliance and internal audit experience and qualifications. Our consultants are Certified Internal Auditors, Certified Professional Accountants, Certified Information System Auditors, Certified Coding Specialists, Registered Health Information Administrators/Technicians, Certified Professional Coders, Licensed Professional Medical Coding Curriculum instructors, Registered and Licensed Practical Nurses and support staff Physicians when diagnostic clinical guidance is necessary to complete the tasks required of the engagement.
- Uses methodology backed by the highest industry standards, including those sanctioned by the Institute of Internal Auditors and the U.S. Government Accountability Office. The result? Integrity our clients can depend on.
- Works with our clients to assure an understanding of the logic used in arriving at our resulting findings and the importance of the observations noted, with additional emphasis of the business risk and the impact non-compliance may have on the organization.
HIPAA Compliance for Law Firms
The HIPAA Final Omnibus Rule (“Final Rule”) expanded the obligations of covered entity Business Associates to comply with Security and Privacy Rules. As a result, lawyers and law firms may now have exposure to civil and criminal liability for noncompliance. HIPAA civil fines for noncompliance can be up to $50,000 per violation (or a maximum of $1.5 million for repeated violations) depending on the degree of culpability and criminal penalties may result in up to ten years in prison.
HIPAA compliance mandates include:
- Maintenance of policies and procedures related to the obligations under the Privacy, Security and Breach Notification Rules
- Education for all staff on the policies and procedures with respect to PHI and ePHI, as necessary and appropriate for the employees to meet their job duties
Altegra Health can help legal professionals navigate their obligations under HIPAA. Altegra offers extensive HIPAA Privacy and Security expertise provided by professionals with deep specialization and experience in:
- Conducting mock Office of Civil Rights (“OCR”) audits aligned with the OCR Privacy and Security Audit Protocols.
- Assessing your HIPAA Risk throughout your organization, including off-site locations.
- Reviewing your processes around Business Associate Agreements, Vendor Management, Breach Management and IT Security Practices.
- Penetration testing of software applications.
- Providing educational programs to your employees, legal team, vendors, contractors and others on the importance of protecting PHI and ePHI.