Best Healthcare Regulatory Compliance Firms in USA

The SAI360 GRC Platform unifies ethics, governance, risk, and compliance activities for all your stakeholders to adapt to changing business environments. Leverage the most connected integrated risk management (IRM) software platform and industry-leading content to see and manage risk from every angle for a more agile, risk-aware culture.

The SAI360 GRC Platform empowers organizations to balance ethics, risk, and compliance through an integrated solution that helps you manage all types of risks while building a risk-aware compliance program. By connecting key functions like compliance, risk, policy, and training with real-time insights and analytics, SAI360 enables you to adapt to evolving regulations while strengthening your culture of integrity.

The SAI360 GRC Platform is built on four core capabilities that work together to drive smarter risk and compliance outcomes—dynamic and automated workflows, seamless integrations that unify systems, AI that identifies emerging risks and opportunities, and analytics that turn data into actionable decisions. Together, they create the most connected ethics, risk, governance and compliance ecosystem built for scale, speed, and strategic impact.

• Dynamic GRC Workflows
• Analytics & Reporting
• Seamless Integrations
• AI-Driven Intelligence

Empower employees to engage with compliance by embedding risk awareness and ethical decision-making into everyday workflows.

• Provide intuitive interfaces and guided steps for easy access to policies, disclosures, and reporting
• Customize training, policies, and processes by role, region, and risk level for greater relevance
• Integrate ethical decision-making into daily tasks to build a culture of accountability

Unify compliance and risk data to build a connected framework that boosts visibility and drives smarter decisions.

• Link data across risk, compliance, audit, and third-party management into a single source of truth
• Automate data updates with real-time integrations from enterprise and third-party systems
• Track trends, compliance status, and key risks with customizable, actionable dashboards

Gain a 360-degree view of your risk and compliance landscape with data-driven insights and industry benchmarks using our IRM platform.

• Benchmark against peers to evaluate program performance and uncover improvement areas
• Use AI-driven insights to spot patterns, anticipate risks, and inform decisions
• Monitor compliance trends over time to measure progress and strengthen program maturity

Explore how each SAI360 module drives value across your GRC program. See how SAI360 solves real-world compliance and risk challenges, end to end. Tailored solutions to meet the unique risks and regulations of your industry.

Unified tools for managing compliance operations and assessing risk, empowering your organization to take a proactive approach to compliance.

• Protection of PHI: Manage HIPAA policies, employee training, business associate agreements, breach reporting, and information blocking requirements.
• Billing/Payment Compliance: Monitor No Surprises Act, Price Transparency, provider directory updates, patient-provider and dispute resolution processes, and website audits.
• Conflicts of Interest: Automate COI disclosure, policy management, employee training, and audit processes.
• Compensation Structures: Track compliance-related incentives/disincentives, manage consequence procedures, and monitor disciplinary actions.
• Quality & Safety: Audit quality and safety issues, track audit plans, create unified board reports, and conduct medical necessity claim reviews.
• Grant Compliance: Manage grant requirements, record retention, training, expenditure documentation, and subrecipient monitoring.
• Telehealth Compliance: Develop/manage telehealth policies, equipment testing, regulatory response, state licensure, and audit coding/billing.
• AI Governance: Monitor AI decision alignment, identify risks, manage training, and assess legal compliance and ethical use.

Transform your compliance strategy with the symplr Operations Platform. Thirty years of healthcare experience meets a game changing platform, designed to connect more dots across risk management and regulatory compliance, eliminate point solutions, and drive outcomes.

symplr Compliance: Healthcare regulations constantly evolve. You need a compliance solution that helps spot and address risks early. Make avoiding compliance, security, financial, and contract risks part of daily operations and save your organization from costly fines and lost revenue.

Spend 45% less time managing and tracking compliance issues.

Easy-to-use tools, calculators and batch analytics reduce hospital error rates by up to 5%. Mitigate the back-office administrative challenges arising from hospital staffing shortages and the ever-changing rates of Medicare. Safeguard your bottom line and empower your staff to leverage automation and analytics for improved efficiencies and enhanced cash collections. With MediRegs, access a comprehensive solution designed to significantly boost your organization's return on investment. Gain precise insights into regulatory, reimbursement, coding, and compliance matters, ensuring a cohesive strategy for success.

Proactively analyze inpatient and outpatient hospital reimbursement. Empower your team with intelligent analytical tools that create up-front efficiencies, reduce manual calculations, ensure accuracy, and maximize revenue.

• Batch calculate 5,000 outpatient claims instantly: up to 100,000 claims per day
• Batch group diagnoses to MS-DRGs, and batch calculate national unadjusted, Medicare Fee for Service, or Medicare Advantage Rates for up to 1,000 MS-DRGs simultaneously

Protect patient revenue and be prepared for audits. Supplying coders with the best tools and resources is a proactive and necessary step toward protecting patient revenue while maintaining compliance.

• 90% of denials are preventable
• Being proactive and coding correctly the first time can save $118 per claim

Protect against audits and the cost of non-compliance. The cost of compliance is on the rise.

• $39 Billion – What hospitals, health systems, and post-acute care providers spend annually on compliance activities
• 17% of healthcare audits in 2021 were Compliance audits, more than any other category, including finance and IT.
• $9.32 million in noncompliance fines in 2021, a 29.5% increase from the year prior

Explore the product suites most critical to you and your clients

• MediRegs Coding: Stay ahead of changing regulation with precise, authoritative information when and where you need it.
• MediRegs Life Sciences: Your complete resource for audit, reimbursement, compliance and regulatory research.
• MediRegs Compliance: Get immediate access to advanced, up-to-date primary source content and expert tools you need to ensure ongoing program and revenue integrity as well as proper audit documentation.

Wolters Kluwer offers a full range of training; from online videos to custom training.

• Register for Training
• Support available via phone and email

The De Facto Industry Standard Enterprise Cyber Risk Management & Healthcare Compliance Software Platform. With the IRM|Pro cyber risk management and healthcare compliance software platform, identify exposures, manage and reduce the likelihood of a breach, save time and money, and meet HIPAA compliance requirements by identifying the unique threats and vulnerabilities applicable to your organization.

With today’s increasing threat landscape and OCR enforcement activity, healthcare providers, payers, and business associates can no longer effectively manage cyber risk or meet HIPAA compliance requirements with “one-size-fits-all” spreadsheets. Many healthcare organizations have turned to Clearwater for cybersecurity and compliance services, adopting IRM|Pro as their enterprise cyber risk management platform.

Our expert system provides an enterprise view of your top exposures and actionable insights to improve your security posture. Efficiently perform an enterprise-wide, NIST-based, OCR-Quality enterprise risk analysis across all ePHI assets and medical devices, evaluate vulnerabilities and threats, assess risk, and manage risk remediation.

A comprehensive healthcare compliance software tool for performing a periodic Security Assessment, as the HIPAA Security Rule requires. Assess compliance with all standards and implementation specifications, identify gaps in your compliance program, and effectively manage remediation actions.

A comprehensive healthcare compliance software tool for managing compliance with the HIPAA Privacy and Breach Notification Rules. Assess your organization’s compliance with these rules, identify gaps in your compliance program, and organize a plan to remediate gaps.

A purpose-built tool for assessing 405(d) Health Industry Cybersecurity Practices in an easier, faster, and less expensive way.

Get in touch with our team to schedule a demo of any of our healthcare compliance software solutions and see how the technology can work for your organization.

Our AI-powered platform helps you raise the standard of care for your patients, workforce and organization.

Connect provider management, safety, compliance, and patient experience to drive efficiency, readiness, and measurable outcomes.

Unifies provider management, connects safety and risk management, unifies policies and regulatory standards, ensures reliable data access, and combines patient feedback and outreach.

• Unifies provider management to accelerate onboarding and day-one billing, ensure compliance, improve visibility
• Connects every part of safety and risk management to help leaders see risk sooner, act faster, and prevent harm
• Unifies policies, audits, and regulatory standards to keep teams survey-ready and aligned with evolving requirements
• Ensures reliable access to historical and live data—migration, archiving, and downtime—for continuity, compliance, and analytics-ready signals
• Combines patient feedback, reputation, and targeted outreach to strengthen trust and grow responsibly

Describes how RLD360 supports provider onboarding, staff scheduling, compliance, event reporting, feedback collection, best practices, data preservation, and reputation management.

• Bring the right providers onto your team
• Get the right people to right place to deliver care
• Ensure follow through on standards of care
• Report and learn from errors, mistakes, variations
• Collect and learn from patient & staff feedback
• Learn from national and regional best practices
• Ensure your data is preserved and maintained
• Promote your reputation and expand patient base

Highlights success stories from leading healthcare organizations using RLD360 Platform.

• Duke Health: 21% increase in event reporting in three years
• Novant Health: Cost reduction, improved data integrity
• Mercy Health: Increased event reporting and visibility
• Saint Francis Health System: Improved collaboration
• Methodist: Improved performance through compliance
• Kaiser Permanente: Modernized document management
• University Hospitals: Aligned mission and safety priorities

USA Health unified provider data, submitted over 900 rounds in less than 2 months, and gained full-spectrum insight into provider performance using RLDatix’s safety platform.

• Over 900 rounds submitted in <2 months
• Full-spectrum insight into provider performance
• Unifying provider data to reduce care variability