A regional healthcare system discovered irregularities in its billing data that suggested fraud, but internal auditors struggled to identify the source or scale. Facing both regulatory penalties and reputational damage, they called on our forensic team. We systematically extracted and standardised five years of billing, claim and patient encounter records, which amounted to over 10 million data points. Advanced anomaly detection tools isolated suspicious codes and flagged provider patterns linked to systemic over-billing. Canali Partners’s forensic accounting revealed €12.4 million in irrecoverable losses but enabled the recoupment of  €14.3 million through negotiation with payers. We also implemented robust, real-time data validation controls, reducing future risk and restoring trust in the system’s operations.