Medical Coding Expert Witnesses

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 is a Professor of Medical Informatics with extensive experience in the proper use of Electronic Health Records. He earned his BS, and MS from Pennsylvania State University and his PhD from the University of Utah. He has held numerous academic appointments at premier medical institutions across the country including, Yale University School of Medicine and Harvard Medical School. He is a member of numerous professional organizations in his field; he is a fellow of the American College of Medical Informatics and a member of the American Medical Informatics Association. He is extensively published, with 250 peer reviewed journal articles in addition to numerous abstracts and presentations. In addition to his research responsibilities, he is quite active in the education of undergraduate and graduate students.

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 in EMR and Hospital Billing systems has worked as a certified Epic consultant with various healthcare providers for the past 7 years. He is currently certified in 10 Epic applications ranging from hospital billing to CDM and ASAP. He has previously held positions as a Senior Epic Consultant at multiple hospitals, as an Epic Instructional Designer, and as an Epic Revenue Cycle Report Writer. He is currently a Senior Epic Hospital Billing Consultant at a large university cancer center in Texas.

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.

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 electronic medical records expert has over 15 years of experience in his field. He has worked with a number of picture archiving and communication systems (PACS) from vendors like Sectra IDS7, GE Centricity, Merge eFilm, and Rad Works. He has formerly served as a computer technician and purchase manager at Apex Radiology and as PACS Administrator at companies such as Apex Radiology, Radisphere, X-Ray Associates of New Mexico, and City of Hope.

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.

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 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.