Our Healthcare Compliance Consulting Agency delivers intelligent, tailored solutions to keep your clinic or healthcare organization compliant while fostering a healthier operational environment. We help healthcare providers navigate complex regulations, minimize risks, and ensure adherence to federal and state laws.
With expert-driven strategies in compliance, audits, billing integrity, and fraud prevention, we handle the complexities so you can focus on what matters most—patient care.
for business
Our team is comprised of professionals with diverse backgrounds, including clinical expertise and deep knowledge of healthcare regulations. This unique blend of skills enables us to provide a holistic approach to healthcare compliance beyond traditional consulting. We leverage insights gained from working directly within the health insurance industry to ensure that your organization remains compliant with ever-evolving regulations while also optimizing operational efficiency.
With experience in healthcare regulatory issues, including the False Claims Act, Stark Laws, and Anti-Kickback Statute, we ensure that your clinic or hospital is protected from legal risks and remains aligned with industry standards. Our bilingual team facilitates clear communication with diverse healthcare teams ensuring smooth collaboration in regulatory matters.
What really sets Premier Healthcare Compliance apart is their personalized approach. They don’t just treat you like another client—they genuinely care about your success. Their team was always available to answer any questions we had, often going above and beyond to ensure we felt supported every step of the way. As a medical billing company, having Premier Healthcare Compliance as a partner has been a huge plus. Their attention to compliance means we can focus on our core services.
One of the key strengths of PR healthcare compliance is its thorough compliance audits and tailored solutions. They identified potential compliance risks and offered clear, actionable strategies to address them. This helped our clinic maintain high standards of care while reducing the risk of costly penalties. They were always available to answer questions, provide guidance, and support us through implementing necessary changes. Thanks to their efforts, we saw significant improvements in our clinic’s operational efficiency and overall compliance.
Face Fines Up to
$100,000 for Non-Compliance
with CMS Rules
Failure to follow CMS guidelines, including overpayments, improper billing, and non-adherence to Medicare or Medicaid, can result in penalties of up to $100,000 per violation under the False Claims Act (FCA).
Reference: U.S. Department of Health & Human Services, Office of Inspector General (OIG). False Claims Act Overview.
Abuse (FWA) Prevention
Fraud Prevention
Programs Cut
Healthcare
Losses by 20%
Healthcare fraud costs the U.S. government $60-80 billion annually, but effective Fraud, Waste, and Abuse (FWA) prevention programs can reduce losses by up to 20%.
Reference: National Health Care Anti-Fraud Association (NHCAA). The Challenge of Health Care Fraud.
Non-Compliance
Costs Average
$14.82M
Per Data Breach
Organizations that fail to meet regulatory guidelines, like HIPAA, face an average cost of $14.82 million per breach, including fines and reputational damage.
Reference: National Health Care Anti-Fraud Association (NHCAA). The Challenge of Health Care Fraud.
Compliance Reviews
Reduce Violation
Risk by
Up to 50%
Regular compliance reviews and risk assessments can lower non-compliance risk by 40% and reduce costly violations by 35-50%, helping healthcare organizations meet regulatory standards.
References: U.S. Department of Health & Human Services (OIG); American Health Law Association (AHLA).
