Randy Forrest began his healthcare career in 1979 as a financial auditor with the fiscal intermediary that is now Riverbend GBA. This initial exposure to healthcare gave him a broad perspective of the industry, in that, he was responsible for managing financial audits for hospitals, nursing homes, home health agencies, comprehensive outpatient rehabilitation facilities, chain operations and off-shore captive insurance companies.
After spending a number of years working for a large hospital chain with responsibility to report and advise facility CEO’s, CFO’s and Controllers with regard to Medicare and Medicaid reimbursement matters he entered the home health industry in 1992 as a CFO.
In 1994, he founded a consulting company providing accounting, cost reporting, Federal and State reimbursement negotiation and fund recapture services for the healthcare industry.
In 2005, he co-founded a home health billing and consulting company and this experience continued to fuel his passion for the home health industry and its mission to provide quality healthcare to our nation’s senior citizens.
In 2012, he founded Regulatory Compliance, LLC dba S.M.A.R.T. Healthcare Resources. The passing of the Patient Protection Affordable Care Act in 2010 ushered in a new world of scrutiny for home health and hospice agencies participating in the Medicare Program. The company entered a Joint Venture with Medicare Training & Consulting in Lansing, Illinois to provide education and training across the country in the areas of home health and hospice compliance, billing, documentation practices and to provide timely regulatory updates to industry stakeholders and employees. He has extensive experience and background working with home health and hospice entities under serious scrutiny from the Office of Inspector General (CIA’s), facing QuiTam complaints, and responding to significant overpayments resulting from CMS Medical Review Contractors (ZPIC, UPIC, SMRC, TPE). He has built a strong team of home health and hospice clinical consultants to assist in advocating for S.M.A.R.T.’s clients, whether that is to provide preventative education or to help them navigate the complex world of compliance and reimbursement retention. Through the experience gained assisting agencies in responding to CMS Medical Review, the S.M.A.R.T. team has become a valuable resource for investors in relation to clinical due diligence reviews.
In 2018, he co-founded S.M.A.R.T. Healthcare Compliance Resources, LLC with partner Mary Lou Roos, RN. The partners saw a significant need in the industry for authoritative and expert clinical and billing compliance services in the home health and hospice industries. In the post-PPACA world we are in, this company exists to provide administrative support to home care and hospice entities to afford appropriate reimbursements and retention of those reimbursements. See more at www.smarthcr.com.
Randy's broad base of experience helps him strike a healthy balance in his consulting engagements of advising clients to maximum financial results in their operations while doing so in an environment of compliance with Federal, State and Insurance Company regulations.