Artificial intelligence is fundamentally changing the due diligence process. From contract review automation to predictive risk scoring, AI tools are compressing timelines and surfacing risks that traditional processes miss. We examine what acquirers must now demand from their advisory teams.

Global markets continue to evolve at pace, and our clients, whether high-net-worth individuals, family offices, or senior finance professionals managing major transactions, require intelligence that is current, practical, and grounded in real advisory experience.

At Smarter Mergers, our advisory practice spans M&A, project finance, trade finance, and capital raising across several global cities. The insights we publish here reflect the transactions we advise, the markets we operate in, and the challenges our clients navigate every day.

Key Considerations

Successful outcomes in this area require careful attention to transaction structure, counterparty relationships, regulatory environment, and timing. Our advisory team brings direct experience from many transactions since 2002 to each client engagement, ensuring that strategic recommendations are grounded in practical execution knowledge.

Healthcare Services Deals: Billing and Reimbursement Risk

In healthcare services, the largest diligence risk often sits in the claims data rather than the contracts. A target's revenue is only as good as its billing, and government payers can claw back money years after it was paid. This is where AI-assisted review earns its place: it can test every claim line against documentation, credentials and payer rules, where a manual review only samples.

Autism therapy shows how quickly this risk can surface. Federal auditors at HHS-OIG have reviewed state Medicaid payments for applied behavior analysis (ABA) one state at a time, finding at least $45.6 million in improper payments in Maine and similar findings in Indiana, Wisconsin and Colorado, mostly for missing session notes, credentials and supervision. Much of this growth has come with private equity's push into ABA therapy, and states are responding with new licensing and accreditation rules.

For acquirers of any healthcare services business, the checklist includes:

  • A claims and coding audit on a statistically valid sample, or on the full data set with AI tools, covering documentation, coding and rendering-provider credentials.
  • Payer mix. Heavy Medicaid or Medicare concentration raises recoupment exposure and sensitivity to rate and rule changes.
  • Overpayment handling. Since January 2025, CMS's 60-day overpayment rule uses the False Claims Act's knowledge standard. An identified overpayment that is not refunded can become a False Claims Act problem, and that liability can follow the business to its new owner.
  • Exclusion screening. Confirm monthly checks of staff and contractors against the OIG exclusion list; payments for services by excluded people must be repaid.
  • Deal protection. Representations and warranties insurers commonly exclude government reimbursement risk, so billing exposure usually needs a specific indemnity, an escrow or a price adjustment.

Advisory Perspective

Smarter Mergers advises clients on transactions from $10M upward, with particular strength in cross-border mandates where our global network and multi-jurisdictional experience creates tangible value. Whether you are a business owner evaluating a transaction, a family office seeking direct investment opportunities, or a senior finance professional with a referral opportunity, we welcome a confidential conversation.

For information only. Not investment, legal or tax advice. See our Disclaimer.