Expert Witness 506639
Ophthalmology
Out of State, Illinois
Bachelor, University of Illinois Urbana-Champaign
Cases
Deposition Experience
Court Testimony Experience
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Cases
Deposition Experience
Court Testimony Experience
Bringing together more than 30 years of clinical experience and specialized expertise in ophthalmic plastic and reconstructive surgery, he offers a combination of surgical insight and advanced knowledge of medical billing, coding, and reimbursement. His clinical work includes general ophthalmology, eyelid procedures, ophthalmic plastic and reconstructive surgery, and injectable treatments, while his concurrent involvement in coding and reimbursement oversight includes responsibility for coding accuracy, compliance, auditing, and payer interactions within a large ophthalmology practice. This dual perspective allows him to evaluate both the medical necessity of care and the financial documentation supporting it, particularly in disputes involving CPT and ICD coding, Medicare and Medicaid compliance, third-party reimbursement, and usual, customary, and reasonable (UCR) billing practices. His experience also includes analysis of medical auditing issues and physician reimbursement practices related to surgical and ambulatory care services.
His background reflects the integration of patient care with leadership in coding policy and compliance oversight. He has served in roles including Chief of Ophthalmology, Director of Coding and Reimbursement, Founder and CEO of a coding and reimbursement consulting organization, and Assistant Professor of Ophthalmology. His work has involved educating physicians and healthcare personnel on coding standards, reimbursement policies, and documentation requirements, while also participating in advisory activities related to CPT coding and third-party reimbursement practices. He has served in leadership and advisory roles with organizations including the American Society of Ophthalmic Plastic and Reconstructive Surgery (ASOPRS), Florida Medicare Carrier Advisory Committee, Florida Society of Ophthalmology, American Academy of Ophthalmology, American Health Information Management Association (AHIMA), and American Academy of Professional Coders (AAPC).
In the litigation arena, he brings more than 20 years of expert witness experience, providing consultation, deposition, and trial testimony in matters involving ophthalmologic treatment, billing disputes, coding audits, and healthcare compliance issues. His work involves assessing the relationship between clinical services and reimbursement claims, identifying coding discrepancies, and analyzing allegations related to fraud, abuse, and improper billing. Supported by board certification in ophthalmology and additional credentials as a Certified Coding Specialist (CCS-P) and Certified Professional Medical Auditor (CPMA), he provides analysis at the intersection of medicine, coding, and regulatory compliance. He has also provided education and mentorship related to compliant coding and billing practices for physicians and medical specialty organizations.
Full Name
Title / Credentials
Contact Information
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Degree Type
Bachelor
Field of Study
Mechanical Enginnering
Institution
Cornell University
Degree Type
Medical
Field of Study
Medicine
Institution
University of Michigan-Ann Arbor
Degree Type
Type
Certification
Certification / License
Ophthalmologist
Issuing Authority
American Board of Ophthalmology
Type
Certification
Certification / License
Coding Specialist, Physician-Based (CCS-P)
Issuing Authority
American Health Info. Management Association
Tags:
Insurance Billing
Medicare and medicaid
Healthcare Fraud
Master
Field of Study
Business Administration
Institution
University of Central Florida
Type
Certification
Certification / License
Certified Professional Medical Auditor (CPMA)
Issuing Authority
American Academy of Professional Coders (AAPC)