Disputes:

Billing and Reimbursement

The Claro Group understands that each participant in the healthcare industry faces its own unique set of challenges in documenting, coding and billing for services all while adhering to differing rules and regulations.  Claro applies individualized approaches to resolve each unique issue.

Claro’s Healthcare disputes team is comprised of talented professionals with forensic accounting, finance, economic and data analytics expertise with extensive subject matter expertise.  This allows us to quickly and efficiently gather and analyze large and diverse data, healthcare transactions, documents and other information to respond to specific issues and quantify damages and potential outcomes.  These solutions include:

  • Damages quantification and liability estimation
  • Litigation and settlement valuation of underlying allegations
  • Data aggregation & statistical analysis of underlying claims and patient records
  • Detailed review of billing and reimbursement data
  • Expert witness services

Claro helps identify and quantify billing and reimbursement issues with both government and commercial payors in response to disputes and audits. Claro has submitted experts report, testified in state and federal courts, and assisted in mediation and arbitration.