Healthforce

What Healthforce does

Healthforce, Inc. is a privately held U.S. healthcare administrative consulting firm founded in 2015 by Brian Meredith, CPC, and headquartered in Warren, Massachusetts (corporate PO Box) with on-site operations at Lemuel Shattuck Hospital in Jamaica Plain, Massachusetts. The firm delivers revenue integrity, billing compliance, coding, and auditing services to physician practices, medical groups, hospital systems, and academic medical institutions, and operates a parallel niche channel serving National Institute of Whole Health (NIWH) graduates with patient health education billing and coding support. The company has roughly 1-10 employees, is bootstrapped with no disclosed institutional funding, and is led by Brian Meredith (President and Founder, 30 years of experience) and Leanne Wu (Director of Client Services, CCS-P, 18 years of experience).

Healthforce sells nine core service modules: Billing Compliance Consultation, Patient Healthcare Advocacy, Chart Auditing (Part A and Part B), Physician and Hospital Department Education (supported by proprietary E/M leveling pocket flashcards), Health Education Billing and Coding Consultation (NIWH channel), Compliance Program Development, Database Management and Training, Inpatient Coding and DRG Validation, and Risk Adjustment Coding and Audits (HCC). Underpinning the service delivery is AuditShield™, a registered-trademark proprietary software that records, tracks, and reports audit findings and applies a risk-based scoring methodology to weight findings, schedule individualized re-auditing, and manage physician/hospital training. AuditShield is positioned as a lower-cost alternative to commercial audit management platforms.

Revenue is generated almost entirely through professional-services consulting fees negotiated on a per-engagement basis, with one transparent reference price of $90 per hour for remote NIWH graduate consultations. The firm runs a sales-led, direct-outreach go-to-market model with content marketing support (company blog and articles in AAPC's Healthcare Business Monthly). No app, API, SDK, integrations, or AI/ML capabilities are disclosed; the competitive posture is built on founder expertise, regulatory credentials, and the AuditShield tooling rather than on software scale or automation.

Name

Healthforce

Legal name

Healthforce, Inc.

Website

https://healthforcecorp.com

Company type

Private

Founded year

2015

Operating status

Operating

Headcount range

1–10 employees

Short description

Healthforce is a privately held U.S. healthcare administrative consulting firm that delivers billing compliance, coding, auditing, and revenue integrity services to physician practices, medical groups, hospital systems, and academic medical institutions, supported by its proprietary AuditShield™ audit-tracking software and a partnership channel serving NIWH graduates.

Ownership category

akta.pro rank

Product category

Healthcare Administrative Consulting

NAICS

Offices of Physicians (62111)

SIC

Services-Health Services (8000)

akta.pro primary industry

Medical Billing & Coding Automation (HLACACAA)

akta.pro secondary industries

Health Information Management (EHR) & Medical Office Administration (EDAOAJAF), Patient Billing, Statements & Payment Processing (HLACACAG), Nursing, Clinical Notes & Documentation Workflow Tools (HLACAAAG)

Keywords

• Healthcare billing compliance
• Medical coding auditing
• Revenue integrity consulting
• Physician practice consulting
• Chart audit services

Headquarters

HQ city

Bothell

HQ country

United States

HQ region

North America

Offices2 records

Markets served

GTM type

B2B

Offering type

Services

Cost components

Personnel, Operations, Technology or R&D, Marketing or Sales

Revenue model

1. Healthcare Administrative Consulting Services: Consulting fees for billing compliance, coding, auditing, and education services for healthcare providers including physician practices, medical groups, and hospital departments.
2. NIWH Consultation Sessions: Remote consultation sessions for National Institute of Whole Health graduates at $90 per hour. In-person sessions available with pricing dependent on specifics.

Pricing tiers

Go-to-market motion1 record

Distribution channels2 records

Marketing channels2 records

Core offering

Healthforce is a healthcare administrative consulting firm that helps physician practices, medical groups, and hospital departments achieve revenue integrity through billing compliance consultation, coding and billing guidance, chart auditing, physician education, and compliance program development. Services are delivered directly by skilled business analysts, auditors, and coders, supported by the firm's proprietary AuditShield risk-based auditing software.

Product overview

Healthforce offers a portfolio of healthcare administrative consulting services centered on revenue integrity through regulatory compliance, coding accuracy, and billing guidance. The core offering consists of nine distinct service modules including Billing Compliance Consultation, Patient Healthcare Advocacy, Chart Auditing, Physician and Hospital Department Education, Health Education Billing & Coding Consultation, Compliance Program Development Consultation, Database Management & Training, Inpatient Coding and DRG Validation, and Risk Adjustment Coding and Audits. Supporting these services is the proprietary AuditShield software, which provides recording, tracking, and reporting of audit findings along with risk-based scoring for physician and hospital department re-auditing programs. The services collectively aim to help client practices and facilities achieve optimal, compliantly collected revenue.

Differentiator

Problem solved

Functional benefit

Brands

• AuditShield™: Proprietary software developed by Healthforce to record, track and report audit findings, and to manage auditing, monitoring and training of physicians and hospital departments

Products and services

• Billing Compliance Consultation Consulting service that guides healthcare providers through regulatory compliance requirements, helping ensure claims survive scrutiny from governmental and third-party payers.
• Patient Healthcare Advocacy Advocacy service helping patients navigate complex medical claims processing, including appointment scheduling, insurance eligibility assistance, claims analysis, and appeal preparation.
• Chart Auditing Comprehensive audit service for Part B and Part A services, reviewing professional and facility billing for technical code requirements and medical necessity compliance.
• Physician and Hospital Department Education Educational services utilizing proprietary E/M leveling tools including specialty-specific E/M pocket flashcards to help physicians achieve accurate coding and documentation.
• Health Education Billing & Coding Consultation Consultation service for patient health educators to support accurate coding and billing for health education services using the NIWH billing and coding manual.
• Compliance Program Development Consultation Service to analyze, modify, and redesign billing compliance programs to help clients achieve optimal revenue integrity through compliantly collected revenue.
• Database Management & Training Risk-based auditing and training service using proprietary AuditShield software to weight findings, score physicians and hospital departments, and develop individualized ongoing re-auditing and training programs.
• Inpatient Coding and DRG Validation Validation service ensuring MS-DRG programs have complete physician documentation including all diagnoses, procedures, complications, and comorbidities for accurate coding.
• Risk Adjustment Coding and Audits Service reviewing Hierarchical Condition Categories (HCC) coding accuracy and physician documentation to ensure proper severity classification and reimbursement under CMS risk adjustment models.

Named customers5 records

Segments3 records

Ideal customer profiles3 records

Technology focussed No

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Feature1 record

Partnerships

One partnership is on record.

• National Institute of Whole Health (NIWH)coreStrategic or Co-development Partner · 1 January 2011Healthforce collaborates with NIWH annually to update the NIWH billing and coding manual for patient health education services. Brian Meredith of Healthforce was contacted in 2011 to assist NIWH, resulting in the annual billing and coding manual now updated by Healthforce. Healthforce offers consultations to NIWH graduates for patient health education billing and coding.

Scale indicators1 record

Recent moves5 records

Expansion highlights4 records

Broad incumbents

• Huron Consulting Group: Large consulting firm with dedicated healthcare practice covering revenue cycle, clinical documentation, and compliance. Operates at materially larger scale than Healthforce with broader service portfolio.
• Hall Render: Healthcare-focused law and consulting firm with deep compliance and reimbursement expertise. Touches Healthforce's niche through healthcare compliance advisory services.
• nThrive: Healthcare revenue cycle management company offering consulting, technology, and analytics services to providers. Overlaps with Healthforce on compliance and coding but operates at enterprise scale.

Others

• AAPC (American Academy of Professional Coders): Professional association for medical coders where Healthforce's founder publishes thought leadership. Indirect peer shaping the compliance/coding ecosystem in which Healthforce operates.

Direct peers

• BESLER: Healthcare consulting firm specializing in revenue integrity, transfer DRG, and coding/billing compliance services. Most direct competitor to Healthforce given focused niche in hospital revenue integrity consulting.
• PYA (Pershing Yoakley & Associates): Healthcare advisory firm offering compliance, coding, and revenue integrity services to hospitals and physician groups. Directly comparable in service mix and target customer base.
• Coker Group: Healthcare consulting firm providing compliance, coding, and revenue cycle advisory to physician practices and hospitals. Closely comparable in service mix and target customer profile.

Regional players

• Kforce: US staffing and consulting firm with healthcare-focused practice providing coding, compliance, and revenue cycle talent. Comparable in serving physician practices and hospitals with administrative support.

Market position

Strengths4 records

Weaknesses4 records

Competitive moat3 records

Key risks5 records

Key highlights6 records

Customer concentration

• LinkedInlinkedin.com/company/healthforce

Revenue estimate

Valuation estimate

Number of profiles

Profiles2 records

Funding overview

Funding rounds

Investors

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A

Investments

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about Healthforce