Expert 521330 - PA

Expertise Description

I have over 20 years of experience in healthcare coding and over 15 years as a compliance expert, forensic coding expert, and consultant. My expertise includes healthcare service coding, documentation and compliance, statistical error rate prediction methods and health insurance fraud involving E/M coding, diagnostic testing and physical medicine services on behalf of both healthcare providers and insurance carriers. I have more than 15 years experience working as a medical billing expert witness in Pennsylvania by providing deposition, consultations and courtroom testimony.

Expert 520849 - FL

Expertise Description

With over 20 years experience in the field of Kinesiology, I have been working as an intercollegiate athletic trainer with a focus in providing orthopedic injury evaluation, physician referral, maintaining medical records and billing, developing rehabilitation protocols, maintaining inventory, coordinating home and away coverage for athletic competition, and acting as an emergency first responder for 9 intercollegiate athletic sports.

Expert 520337 - CA(S)

Expertise Description

I have over 35 years experience in Emergency Medical Services (EMS) Billing and have worked as an EMT with a focus on the pre-hospital care environment in a number of areas, including Neonatology, Pediatrics, Cardiology, and Emergency Response. I have also provided Fire Departments and Private Ambulance Companies with pre-hospital care billing and collections efforts as the Director of Operations for an EMS billing and collections center, directing the work of seven subordinates, and indirectly—more than fifty billing and collections clerks and customer service agents. I have additional experience as a police officer and was listed as one of the inventors of a “patient-pending” solution that covered a set of procedures and technology for a complex ems data collection and billing system.

Expert 508547 - TX

Expertise Description

I have more than 15 years experience in the field of Medicine with expertise as a Nurse Practitioner. I specialize in pediatric acute, emergent, and critical care. I have developed and operationalized new model of care and service line from inception including: facilities, staffing, marketing, operations, purchasing, orientation and evaluation. As well as provided guidance and recommendations for changes in advanced practice nursing congruent with current and anticipated professional, state and billing mandates. I have over 5 years expert witness experience with consultation, deposition, and courtroom testimony.

Expert 508368 - AL AK AZ AR CA(N) CA(S) CO CT DE DC FL GA HI IA ID IL IN KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WY WI

Expertise Description

I have more than 20 years experience in the Healthcare system with expertise providing opinions in civil and criminal matters of health care claims reimbursement, billing and coding, fraud, ICD-10, HIPAA Privacy and Security, Meaningful Use, the Affordable Care Act, and usual customary and reasonable medical costs. I have experience with electronic health records, medical and dental claims, and patient’s duty to mitigate costs. My work involves self-insured employers, hospital systems, health plans (insurance) and healthcare IT firms. My education includes: USC – business, UCI – computer science & economics, Stanford Medical School in bioinformatics, computational biology and biomathematics. I have prior expert witness experience with consultation, deposition, and courtroom testimony.

Expert 507332 - FL

Expertise Description

I have more than 25 years experience in the field of Medical Coding and Billing with expertise in ICD-9, ICD-10, and CPT coding. I have a comprehensive knowledge of the processing of medical insurance claims in a physician's office, to include the posting of payments, claims management as well as collection and tracking of revenue received from patients and third party payers including Medicare, Medicaid and various others. I am certified as a Reimbursement specialist, with training and experience in electronic billing to Medicare, Medicaid, and various insurance plans through several clearinghouses. I am also certified in Medical Chart Auditing, and as a Professional Coder and Instructor, and also as a Medical Billing Specialist.

Expert 55215 - CA(S)

Expertise Description

I have over 15 years experience as healthcare administrator, CEO, and former COO of national healthcare and physician management companies. I have experience with health administration issues, including: project management, staff development, practice analysis, expansion, and operational and financial management. My expertise includes A / R and collections, revenue enhancement, claims processing, acquisitions, mergers, investments, human resources, training, staff development, contracting, marketing, and product line management. I have prior expert witness experience.

Expert 42363 - AZ CA(S)

Expertise Description

I have over 35 years experience with litigation-related financial analysis in publicly traded and private companies. My expertise includes forensic accounting, damage analysis, audits, valuation of businesses and intangible business assets, economic studies, and royalty and fraud auditing. I have more than 30 years expert witness experience with consultations, deposition, and courtroom testimony.

Expert 18334 - CA(S)

Expertise Description

I have over 40 years experience as a professional nurse. My areas of expertise include review and summary of medical records, assessment of damages and liability, medical bill review, and audits related to organizational compliance. I have experience in elderly care, elder abuse, personal injury, professional negligence, and product liability issues. I have more than 20 years expert witness experience with consultations, deposition, and courtroom testimony.

Expert 324124 - CA(S)

Expertise Description

I have more than 30 years experience in Pharmaceutical Economics. My areas of expertise include health economics, pharmaceutical economics, government health care programs (e.g., Medicare, Medicaid, Affordable Care Act), health care market organization, drug legalization policy, cost effectiveness & cost/benefit analysis, comparative effectiveness and outcomes research, hospital costs, treatment selection bias, microeconometrics, health care demand estimation, vaccine policy, HIV/AIDS medical costs and epidemiology, health insurance reform and consulting, evidence-based disease management, and economic assessment of medical technology.

Expert 456766 - NY

Expertise Description

I have more than 30 years experience in the field of Health Care Management with expertise in corporate and healthcare compliance, risk assessment and management, and utilization review. I have experience in Medicare and Medicaid regulations and compliance; clinical documentation, coding, and billing auditing. I have additional experience with: Medico-Legal, medical necessity, medical records analysis, health care billing analysis, educator and staff training, ligation support, fraud & abuse, HIPAA (privacy & security), quality management, and investigations. I have prior expert witness experience.

Expert 450576 - AL AK AZ AR BC CA(N) CA(S) CO CT DE DC FL GA HI IL IN KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WY WI

Expertise Description

I have more than 35 years experience in the field of Emergency Medical Technician-Paramedic (EMT-Paramedic) with expertise in emergency medical service program planning and implementation, development of EMT and paramedic training programs, health care financial management, emergency medical and trauma centers, EMS communication, and the ambulance industry. I have additional experience in emergency department management, trauma care management, rural EMS solutions, emergency department reimbursement, emergency medicine compensation, emergicenter models, assistance to public health officers on studies of healthcare services in County Jails, advanced cardiac life support instruction, and cardiopulmonary resuscitation training. I have over 30 years expert witness experience with consultations, depositions, and courtroom testimony.

Expert 317324 - CA(S)

Expertise Description

I have over 30 years experience in healthcare financial management. My expertise includes receivables experience in acute hospitals, HMO/PPO, law firm, medical groups; medical charges, claims; payments; collections; benefits; contractuals; medical claim valuation; Medicare; Third Party Payments; Charge/Medical Audits; analysis of charge accuracy; discounts in payer/provider agreements, etc. I have over 5 years expert witness experience with consultations, deposition, and courtroom testimony.

Expert 362403 - CA(N)

Expertise Description

R.H.I.A., C.C.S., C.C.D.S. – Consulting expert with more than 15 years experience in the field of Healthcare Management. Expertise includes guidance and dissemination of educational information relating to management analysis; compliance of quality healthcare clinical data; coding; billing to health information professionals; and other related fields. Additional experience involves providers and payers in relation to comprehensive reliable coded healthcare data; clinical data based on coding principles; clinical documentation; and Case Mix Index and reimbursement. Prior expert witness experience. Consultations and deposition.

Expert 371474 - CA(N) NV

Expertise Description

I have more than 30 years combined medical and legal experience. I am a Registered Nurse Attorney, Certified Life Care Planner (CLCP), and Certified Medicare Set-Aside Consultant (MSCC) with extensive Critical Care / Emergency Medicine background, as well as a former Mobile Intensive Care Nurse. My experience includes development of comprehensive Life Care Plans and / or Opposing / Rebuttal Life Care Plan Critiques, as well as Preliminary Life Care Needs and Cost Analyses for the following types of cases for all age groups: multiple trauma, burns, traumatic brain injury, spinal cord injury, orthopedic injuries, amputations, psychiatric disorders, organ failure / transplantation, chronic pain (CRPS / RSD), etc. I have experience reviewing medical records for reasonableness and necessity of treatment, independent medical examinations, as well as potential legal issues, while compiling a relevant chronological Medical Records Summary. I have experience in deposing physician experts and other life care planners, including preparation of concise deposition summaries. I have prior expert witness experience with consultations, deposition, and courtroom testimony.

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Expert 321751 - CA(N) CA(S) CO CT DE FL MI NJ NY PA TX WV

Expertise Description

I have more than 35 years experience in Healthcare Management Consulting, Litigation Support, & Hospital Operations. I have extensive experience with complex healthcare-related litigation pertaining to third party billing disputes, identification of breach of standards of care in the operation of hospitals, nursing homes and ambulatory care environments, physician credentialing in both hospital and managed care organizations, hospital and medical staff bylaws, interpretation of JCAHO standards, JCAHO credentialing, negligent hiring, managed care contracting, administrative and billing compliance, economic analysis related to enterprise value, and fair market value compensation. My regional and national consultations include market planning, product line initiatives, operations improvement, business valuations, medical staff development, hospital-physical joint ventures, healthcare system reorganization, group practice formation, third party contract review and negotiation, and physician and hospital business office issues. I have over 10 years expert witness experience with consultations, deposition, and courtroom testimony.