Medical Billing Expert Witnesses

This highly experienced director of nursing for a 180 bed skilled nursing, assisted living and independent living community has over ten years of experience as a multi-state regional nurse manager. Her current position involves supervision of 150 team members to include the physicians, nurse team, floor nurses, social workers, infection control, quality assurance, medical records, a commissary and recreation therapy. She spent three years as a clinical nurse specialist. She is a registered and certified nursing home surveyor. She spent many years as a regional nurse consultant and recently received a Medicare/Medicaid deficiency free survey.

This life care planning expert earned a masters degree in Vocational Rehabilitation Counseling from the University of Southwestern Louisiana. He is a certified life care planner and a licensed vocational rehabilitation counselor. He belongs to the International Association of Rehabilitation Providers and the International Academy of Life Care Planners. He is currently a self-employed life care planner and vocational consultant.

This qualified expert has over 17 years in healthcare administration, medical accounts, and medical billing matters. She received both an A.A. and B.S. in Health Care Administration from the University of Phoenix. Her previous positions include managerial positions in medical billing departments at various companies including Johns Hopkins, GE Healthcare and LifeBridge Health. She currently works as an Office Manager at a major university hospital. She is responsible to manage staff that includes providers, nurses and administrators. Facilitating contacts between patients and medical staff as well as maintaining, patients, office reports, inventor, appointments and etc. She has also consulted for medical billing requests.

This expert has over 30 years of experiences with securities, investments, and insurance at the financial advisor, supervisory, and managing principal level. He has his producer's license in life, accident, and health insurance, is a certified financial planner, a chartered financial consultant, and a chartered life underwriter. He is also a member of numerous prestigious organizations in the insurance and financial services fields. This expert is is a former agency manager at John Hancock Financial Services, former managing principal at Waddell and Reed and a former Adjunct Professor in the department of finance at the University of Connecticut. He is currently an adjunct professor in financial management at a top university and the founder/consultant at a securities, insurance, and financial services expert witness and litigation consulting firm.

This expert is a well experienced health insurance expert, as she has been involved in multiple company's Revenue Cycle Management programs for the past 15 years. She has been involved with negotiations with pharmacies and physicians, and has in depth knowledge of how to work with the Pharmacy Benefit Managers group to effect drug pricing.

This highly qualified expert has extensive experience with Medicare Set Asides (MSA), Complex Medical Cost Projections and Life Care Plans. She is dual-certified as a Life Care Planner and Medicare Set Aside Consultant among many more with 30+ years working alongside insurance companies. She has past legal experience, court testimony regarding Medicare Set Asides and Medical Cost Projections. This expert is the Vice President and business owner of a medical consulting firm for 17 years. The focus of her company is to ensure each and every client is given the necessary actions to plan for future medical costs. Although her office is based out of Virginia, she caters to a large group of clientele nationwide.

This experienced nurse life care planner maintains clinical expertise in cardiovascular disease, chronic pain, brain injury, amputations, burns, and trauma. For 20+ years she has provided life care planning and case management services to clients. Prior to her life care planning career, she gained hands on experience as a nurse at New York University Medical Center and Robert Wood Johnson University Hospital.

This board certified physician is currently an active consultant in medical billing compliance, device and drug marketing, and claims data analysis. He has recently been involved as consultant and expert witness in Medicare criminal and civil litigation, Qui Tam cases and administrative hearings. The expert recently served as a Medical Consultant for ICD-10 transition, coding, and policy at PricewaterhouseCoopers; he now runs his own consulting business and assists clients with all areas of Medicare coverage and billing.

This highly qualified expert has 35+ years of experience in the healthcare arena ranging from hands-on clinical to the executive level of operations. He specializes in medical billing, collections, and in the financial performance of businesses, along with business practices. He received his BSN degree from Arizona State University and his MBA degree in finance from the University of Southern California. He is a member of the advisory board at Hearing Healthcare Providers of California and his previous responsibilities included senior level positions at Kaiser, Paracelsus and Adventist Health Medical Groups, as administrator, regional business development director, and COO. This expert is currently the founder of a major medical revenue management firm, where he currently works.

This expert has over 60 years of experience in the field of insurance. He earned his BS at David Lipscomb University and is a Licensed Property and Casualty Insurance Agent, as well as a Life and Health Insurance Agent. He a certified Chartered Property and Casualty Underwriter, as well as an Associate in Risk Management. He is active in his field as a member of the National Chartered Property Casualty Underwriter Society, and has published on topics relating to the field of insurance. He has previously served as the Vice President of Tennessee Underwriters, and for the last 17 years has served as the President of an insurance consulting service in Tennessee.

This expert has extensive credentials and training in nursing, nurse life care planning, and medicare consulting. She belongs to the American Association of Legal Nurse Consultants, the American Association of Nurse Life Care Planners, and the National Association of Medicare Set-Aside Professionals. She has held numerous nursing positions throughout the mid-west and is currently a nurse life care planner and consultant at a private firm in Indiana.

This expert has over 30 years of experience with healthcare and health insurance. She gained her PhD in sociology and health policy at the University of California, Santa Cruz and directed research at the Institute of Health and Aging at UC San Francisco before leading the White House's Health Care Reform Task Force. Since, she has continued to contribute to the private and public sectors, working as a principal at William M. Mercer, Inc, the vice president of the Lewin Group, an associate professor of research at UC Santa Cruz, and the consumer representative to the Medicare Coverage Advisory Committee. Her most recent roles include consulting for Watson Wyatt Worldwide, the Center for Medical Technology Policy, and Bain & Company. Currently she is an independent health care consultant.

This expert is a certified legal nurse consultant and a registered nurse. She has has many positions as a nurse and now works as a life planner and nurse consultant at three different practices. She is certified as a life care planner and in life accident and health insurance.

Healthcare consulting and management executive with thirty-six years of progressively responsible experience in assisting community hospitals, multi-hospital systems, academic medical and research centers, nursing homes and assisted living facilities, managed care organizations and large physician entities achieve strategic business objectives. Extensive involvement in complex healthcare-related litigation pertaining to identification of breach of standards of care in the operation of hospitals, nursing homes and ambulatory care environments, negligent hiring, physician credentialing in both hospital and managed care organizations, interpretation of JCAHO standards, hospital and medical staff bylaws, third party billing disputes, administrative and billing compliance, managed care contracting, economic analysis related to enterprise value and fair market value compensation analyses. Consistent proven ability to conceptualize, analyze and implement effective approaches and solutions to enhance strategic position, operational effectiveness and financial results of healthcare organizations. Regional and national consulting experience includes market planning, product line initiatives, operations improvement, business valuations, medical staff development, hospital-physician joint ventures, healthcare system reorganization, group practice formation, third party contract review and negotiation, physician and hospital business office issues.

This highly qualified expert has been a registered nurse for over 35 years. She has worked as a rehabilitation and intravenous nurse in both the hospital and home health care setting in OH. She has been a certified life care planner and case manager for 15 years and a certified nurse life care planner for over 5 years. She is also a certified brain injury specialist by the Brain Injury Association of America. She is a member of several professional organizations including the American Association of Nurse Life Care Planners, where she previously served in many roles including President and Secretary. She currently owns a medical consultancy firm in MA, through which she creates life care plans for patients with spinal cord injury, traumatic brain injury, cerebral palsy, and other chronic disabilities. She also prepares Medicare set-aside cost projections for worker's compensation and litigation settlements.

This highly qualified expert has been in the field of nursing for over four decades, with demonstrated experience in the areas of life care planning, medical cost projection, Medicare set asides, medical damage reports, and medical bill reviews. She received her BSN from Saint Olaf College and then her MS in nursing from Ohio State University. She is a registered nurse, as well as a certified legal nurse consultant, lifetime nurse care planner, medicare set aside professional, and nurse life care planner. She is a member of numerous professional societies, including the American Association of Legal Nurse Consultants and the American Association of Nurse Life Care Planners and has presented on topics in nursing multiple times. She has held a wide variety of roles during her career including as the owner and manager of Home Health Care Consultants. She has also worked as an office nurse for a primary care physician and as a home care liaison at St. Mary’s Regional Medical Center. Currently, she is the owner and CEO of a legal nurse consultancy in Nevada.

This board-certified internal medicine and medical coding expert received his BA in zoology from Miami University before earning his MD from Loyola University. He subsequently completed an internal medicine residency at the University of Illinois. He is certified as a professional coder by the American Academy of Professional Coders, and holds additional certifications in advanced cardiac life support and basic life support. As a professional coder, this expert has experience that includes auditing of ICD-10, CPT, and HCPCS level II coding. He formerly served as a locum tenens physician in hospital medicine at Monroe Clinic and a physician advisor for South Florida Utilization Review. Currently, this expert serves as a hospital medicine physician for multiple hospitals in Illinois, a physician advisor for an independent medical review organization, and the medical director of a medical review organization in Georgia.