Prognosis Consulting is a boutique healthcare revenue cycle and compliance advisory firm based in Metro Atlanta · Nationwide Remote. We work with independent hospice operators, post-acute agencies, SNFs, home health agencies, and physician practices — organizations that are too sophisticated for generic templates and too lean for a full-time compliance department.
Most compliance consultants operate from one of two positions: reactive, after the audit has landed, at legal prices — or from the template vendor side, where the deliverable is a PDF and the relationship ends at download. Prognosis sits between those two positions deliberately.
We work from operator-level RCM experience — the kind built inside a multi-provider health system, running claims through the same workflows our clients use daily. That background produces a different kind of engagement: one that recognizes the actual failure patterns before they become findings, and delivers conclusions in language that an administrator or compliance officer can act on without translation.
Every engagement is fixed-fee, scoped in writing before work begins, and delivered as a document your organization can place in a compliance file, hand to a surveyor, or use as the basis of a corrective action plan. We do not issue ambiguous recommendations. We issue findings.
Coding audits, CPT utilization analysis, AR and denial review, bad debt recovery, and provider directory integrity. We find the revenue your organization has already earned but hasn't collected — and identify the billing patterns that will attract auditor attention before they do.
LEIE exclusion screening, OIG Work Plan readiness, hospice PPEO and cap liability analysis, ADR/TPE response, SNF F-tag remediation, and compliance subscriptions. We audit against the current regulatory environment — not the environment from five years ago.
Our practice is built at the intersection of operator-level revenue cycle experience and current regulatory enforcement priorities. Each engagement is grounded in the specific compliance and billing frameworks that govern our clients' industries.
Every engagement is defined in writing before a single hour is billed. Scope, deliverable, fee, and timeline — confirmed in advance. No scope creep, no surprise invoices, no "and also" conversations at the end of a project.
We issue findings documents, not observation memos. Every finding is tied to a specific regulatory citation, a quantified exposure where applicable, and a recommended corrective action. The deliverable should be usable — in a compliance binder, in front of a surveyor, or as the basis of a board presentation.
The OIG Work Plan publishes what auditors will prioritize next year. Palmetto GBA's TPE edit lists publish what they're targeting this quarter. We audit against both — proactively — so the organization is defensible before enforcement finds it, not after.
We don't take referral fees, don't sell software, and hold no financial interest in any vendor we evaluate or recommend. Our only revenue is the engagement fee — which means every conclusion we deliver is structurally free of conflict. When we tell an organization that a billing pattern is high-risk or a vendor is underperforming, that determination is ours alone.
Discovery calls are 30 minutes, no charge. We'll confirm whether the engagement scope fits our practice and give you a fixed-fee quote on the call. If it doesn't fit, we'll tell you that too.