Warning on healthcare insurance audits

searcher profile

January 10, 2026

by a searcher from Harvard University - Harvard Business School in Williston Park, NY, USA

Hi folks - PSA for anyone buying insurance-based healthcare companies: do a billing-compliance review early. Ask for payor correspondence, audit and recoupment history, overpayment logs, denial trends, and whether any repayments or self-disclosures have been made. Have specialized billing and healthcare counsel review coding, authorizations, supervision requirements, and payor contracts. If a seller won’t provide documentation or dismisses compliance questions, treat that as a major red flag. Theres a healthcare company right now on a major marketplace in a hot space that I know have a lot of people looking at it but has significant clawback liability (tune of a few million) and is trying to unload to a buyer and hoping they dont catch it. If you dont know healthcare billing, be careful and ask early! I hope this can save others time and money. Good luck out there!
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