Healthcare Fraud Investigation Expert 535720

Expertise Description

I have over 25 years experience in Healthcare Fraud Investigations with expertise in conducting comprehensive audits and investigations for fraud, waste, abuse, and error (erroneous coding) for Medicaid, Medicare Advantage, and commercial products. I have prior expert witness experience.

Healthcare Management Expert Witness IL 533318

Expertise Description

I am an experienced healthcare management expert witness. I have specialized for over 35 years in general medical data audit support services, data analytics (predictive), data assessments and strategy support, internal control audits, compliance, risk, and vulnerability assessments for patients, providers, payers, plan sponsors and other indirect and direct support vendors within the healthcare industry. I have additional experience in denial management services, third party audits, metrics, medical software architecture and integration analysis and health record integrity that are essential to sustain revenue, billing and clinical integrity. I have prior experience offering consultations, deposition, and courtroom testimony as a healthcare management expert witness.

Health Claims Audit Expert Witness Alabama 533150

Expertise Description

I have worked in health claim audits for more than two decades. My expertise is in workers compensation bill/invoice audits, provider network discount audits, insurance policy compliance, medical billing, accidental injuries, insurance policy language litigation, medical billing processes, hospital accounts receivables processes, and estimates on future medical costs. I have spent over 15 years providing consultations and deposition for numerous clients as a health claim audits expert witness.

Medical Billing Expert Witness FL 532119

Expertise Description

My expertise is in medical billing, having spent more than two decades working with billing and collections. I have experience as a medical billing manager and orthopedic account manager. I am offering my services as a medical billing expert witness.

Healthcare Expert Witness 532318

Expertise Description

I have worked in the healthcare industry for over 35 years. My expertise is in nursing, healthcare advocacy/advisory, health insurance benefits, resolving claim disputes, obtaining approval for services, maximizing benefits, and improving quality of care. I have prior experience offering consultations and courtroom testimony as a healthcare expert witness.

Healthcare Industry Expert Witness FL 532153

Expertise Description

With more than two decades working in the healthcare industry, I have expertise in medical billing & coding medical practice operations, business development, profit and loss, budget administrations, Medicare compliance, contract negotiations, medical records administration, budgets and expenditure, medical facility construction projects, and regulatory compliance (HIPAA). I am offering my services as a healthcare expert witness.

Medical Billing & Coding Expert 501916 NJ

Expertise Description

With over 15 years experience in medical billing and coding, I have worked with Eclaims, Zyantus, Accuchecker, Medisoft, Billflash, Crystal Reports, Navinet and Emdeon for a variety of medical practices and specialties. I am offering my services as a medical billing and coding expert witness.

Medical Billing & Coding Expert 524692 LA

Expertise Description

I have over 15 years experience in Medical Billing & Coding with a focus in education, healthcare compliance, government regulations, electronic health record development and implementation, and healthcare management. I have prior experience providing my services as a medical billing and coding expert witness.

Medical Billing Expert 523597 UT

Expertise Description

I have over 20 years experience working with medical billing. My expertise is in claims, billing, data analysis, operations, review of claim submission, processing and supporting documentation. I have spent more than 15 years as a medical billing expert witness by offering deposition, consultations, and courtroom testimony.

Medical Billing Expert 523510 CO

Expertise Description

I have more than 15 years experience in the medical billing field. I have an expertise in medical coding, auditing, HCC coding and comprehensive auditing, and medical coding compliance. I have prior experience offering my services as a medical billing expert witness.

Medical Billing Expert 523506 CO

Expertise Description

I have over 15 years experience in medical billing. I have worked with policies and procedures for billing, collections, coding compliance, reimbursement policies, denials, refunds, collections, and accounts receivable, using MicroMD practice management software and Praxis Electronic Medical Records software; computed data for monthly reports and annual executive reports; billing, collection, scheduling, and records maintenance. I have prior experience offering consultations, courtroom testimony, and deposition as a medical billing expert witness.

Medical Billing Expert 521415 OH

Expertise Description

I have spent more than 15 years as a medical billing expert witness. I also have over 20 years experience in Medical Billing and Coding with expertise in medical record audits and reviews, compliance plan requirements, corporate integrity agreement (CIA), due diligence, independent review organization (IRO), Medicare and Medicaid fraud and abuse investigation, and physicians at teaching hospitals (PATH) initiatives.

Medical Billing Expert 521388 CT

Expertise Description

I have over 25 years experience in the medical billing and coding field. My focus is in CPT codes, billing & coding, compliance, accounts receivable reduction, bill review, personal injury bill reduction, bill analysis, and UCR pricing. I have spent more than a decade as a medical billing expert witness.

Medical Billing Coding 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.

Kinesiology 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.

Emergency Medical Billing 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.

Pediatric Acute Care 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.

Medical Billing and Coding Expert 508368 AL

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.

Medical Chart Auditing 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.

Healthcare Administrator 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.

Intangible Busines Assets Expert 42363 AZ

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.

Medical Biling 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.

Pharmaceutical Economics 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.

Healthcare Management 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.

Safety Expert 450576 AL

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.

Medicare And Medical Billing 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.

Healthcare 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.

Registered Nurse Expert 371474 CA(N)

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.

Healthcare Management Expert 321751 CA(N)

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.