Independent Medicaid Investigations
When allegations arise or internal concerns emerge, having a neutral, knowledgeable third party is essential. RCOM Consulting provides independent Medicaid investigations and compliance reviews for healthcare providers, attorneys, and agencies in Kentucky.
We do not represent the state or any legal authority—we offer objective, documentation-based reviews to help organizations assess risk, resolve disputes, or prepare for potential audits and enforcement actions
We Investigate:
✅ Internal Provider Issues
Misapplication of Medicaid policy within practice operations
Discrepancies in billing, documentation, or staff conduct
Review of training gaps, supervision problems, or policy enforcement issues
✅ Pre-Audit & Post-Audit Analysis
Assistance reviewing findings or state correspondence
Identifying weaknesses before formal CHFS or OIG audits
Clarifying technical criteria violations or resource misclassification
✅ Public Assistance & Medicaid Eligibility Fraud
Reviewing eligibility documentation when fraud is alleged or suspected
Supporting attorneys or agencies with background research and timeline validation
Providing written documentation support for use in internal proceedings or hearings
What Makes RCOM Different?
Deep knowledge of Kentucky Medicaid policy, procedure, and real-world enforcement
Familiarity with CHFS, OIG, and DCBS guidelines
Documentation-first approach, no guesswork, just informed analysis
Professional neutrality, we don’t take sides, we uncover facts
Need an independent investigation into a Medicaid compliance issue or provider concern?
RCOM delivers the clarity and insight you need to move forward with confidence.