Health Care Fraud Experts
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Expertise Description: C.F.E., F.A.C.F.E.I., D.A.B.F.E., C.M.I.-II, F.H.F.M.A. - Expert in health care consulting with more than 40 years experience in the health care industry. Experience includes: medicare and other regulatory compliance audits, medical necessity and documentation audits, audit protocol, and patient accounting systems and billing activities. Additional experience performing valuation analyses and risk assessments. Certified Fraud Examiner (C.F.E.). Fellow, American College of Forensic Examiners (F.A.C.F.E.I.). Diplomate of American Board of Forensic Examiners... » Read Complete Profile
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Expertise Description: C.P.A./C.F.F., C.F.E. - Consulting practice focusing on litigation services as well as federal tax services and practice management consulting for professional firms. Has more than 40 years of experience practicing public accounting. Was one of the first to receive Certified in Financial Forensics (C.F.F.) credential from the AICPA. Is a member of the AICPA's Forensic and Litigation Services Committee. Conducts forensic investigations and serves as consulting expert, and/or testifying expert... » Read Complete Profile
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Expertise Description: Consulting expert with more than 40 years of wide-ranging experience in the insurance industry. Expertise includes: insurance, risk management, insurance fraud, property insurance, life insurance, disability insurance, excess and surplus lines insurance, homeowners insurance, and workers compensation. Additional expertise in aviation insurance, marine insurance, yacht insurance, liability insurance, errors and omissions insurance, bad faith, insurance claims, excess and umbrella insurance, offshore insurance, duty of care insurance, and custom and practice... » Read Complete Profile
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Expertise Description: MBA, CLU, AEP – Consulting expert in Insurance and Finance with more than 25 years experience in the field. Expertise includes: standard of care involving representations, presentations, sales and placement of life insurance products by licensed agents and Registered Representatives (who sell life and annuity products qualifying as “securities”); supervision issues of broker dealers and their registered representatives; suitability issues surrounding the sale of securities by registered representatives; assessing and... » Read Complete Profile
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Expertise Description: Pharm.D. – Consulting expert with more than 35 years experience in pharmacy risk management, pharmacy- and pharmaceuticals-related litigation, third-party drug benefits, and freelance writing for the healthcare communications industry. Has been a practicing clinical pharmacist, a hospital pharmacy director, a regional hospital pharmacy administrator, and a consultant in private practice. Expertise includes medical and pharmaceutical writing and editing; drug information; pharmacy practice and operations; risk assessment and management; clinical pharmacy... » Read Complete Profile
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Expertise Description: Experienced in insurance claim, coverage, and bad faith. Over 14 years claim experience, from claim rep to supervisor. More than 25 years as coverage and bad faith defense lawyer with 24 published and unpublished appellate cases. Qualified trial testimony in over 100 trials involving first and third party claims, underwriting, legal malpractice, coverage, rescission, reformation, cancellation coverage, and advice of counsel. Testimony for both policy holders and insurance companies... » Read Complete Profile
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Expertise Description: M.B.A., M.A. - Economics expert with almost 10 years experience in the field. Expertise includes wage and hours class-action cases in industries such as packaging, hospitality, health care, distribution, entertainment, printing, mining, and government. Wage and hours issues have included overtime, meal breaks, independent contractor vs. employee, temporary vs. regular, work off-the-clock, and exempt vs. non exempt. Experienced in business litigation cases involving breach of contract, royalty fees, business interruption... » Read Complete Profile
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Expertise Description: D.M.D., M.S. – Consulting Dentistry expert with more than 25 years experience in the dental field. Expertise includes: clinical dentistry (multidisciplinaru); coding / insurance; standard of care issues; informed consent; medical violations / fraud; TMJ injuries, periodontal care / tooth support; anesthesia; oral surgery / exodontial / implants; prosthodontics (crowns, bridges, dentures); record keeping / documentation; treatment planning; dental materials; and quality assurance / risk management. Doctor of Dental Medicine... » Read Complete Profile
