Joan Gilhooly is an experienced health care consultant with expertise in health care reimbursement, medical coding, revenue cycle management, Medicare and Medicaid program regulations, payor appeals and litigation support across a broad range of health care disciplines, including physician practices, hospital outpatient services (including provider-based clinics), laboratories, rural health centers, hospices and DME suppliers. Her clinical background as a medical technologist and 20+ years as an independent consultant, combined with decades of mid-to-senior level operational experience in the health care industry, provides a solid foundation for guiding legal teams and health care providers on the integration of quality health care delivery with efficient and effective reimbursement compliance.

Joan leverages this expertise in her work on behalf of health care providers, regularly performing in-depth outpatient hospital, professional and supplier claims reviews, assisting with regulatory and sub-regulatory research, applying payor coverage policies to clinical findings, verifying appropriate CPT/HCPCS code utilization and much more. Her technical knowledge and practical experience help teams analyze complex information and develop effective strategies for health care clients. This work is often in response to administrative audits, federal investigations, reimbursement litigation, health care due diligence transactions or other provider compliance concerns.