HMO Expert Witnesses

Internal Medicine, Hospitalist - Medical Director, HMO, Medicare Advantage, Insurance, HCC, RAF, Coding, Billing, Contracts

Dr. Ji is a Los Angeles based board certified internal medicine physician with experience as a medical director and practicing hospitalist physician since graduating residency in New York in 2013 (Columbia University/New York Presbyterian Hospital). Since then he has had: 10+ years of experience as a hybrid hospitalist and office based internal medicine physician in active practice 7+ years of medical director experience for two large medical groups (Regal Medical Group and Caremore) Additional experience and expertise include clinical and management expertise in: -value based care and risk bearing models of care -PCP/specialist and hospital contracting -HCC/RAF coding -STARS/HEDIS -High risk population management (inpatient and outpatient) -Insurance based bed day management (inpatient/observation determination, and out-of-network and patient transfer management) -Extensive case review experience with physician quality/standards, hospital coding, appeals determination including...

HMO, Medical Management - Accountable Care, HMO & Managed Care, Appeals & Grievances, Hospital & Provider Credentialing, Utilization/Medical Necessity, Healthcare Fraud/Abuse, Utilization Review, Qui Tam, Physician Quality of Care, Physician Sanctions, Defamation, Disruptive Physicians, Population Health, Sleep Medicine

AMERICLIN® FORENSIC CONSULTING (AFC) is a physician-led collaborative of skilled consulting clinical expert witnesses. There are currently over 50 clinicians in the AF network who seek to provide case-winning strategies for lawyers nationwide. Upon contacting us, we provide a no-charge consultation to discuss the case. Our full suite of services includes: • Free initial phone consultations with expert clinicians • Flat fee initial case reviews • Dynamic clinical case theory analysis and development Phone: (843) 949-0927 Email: [email protected] AREAS OF EXPERTISE: Accountable Care Organizations Appeals & Grievances Case Management Correctional Healthcare Disease Management Disruptive Physicians Elder Abuse Emergency Medicine Geriatrics Healthcare Fraud/Abuse HMO & Managed Care Hospital & Provider Credentialing Internal Medicine Medical Insurance Medical Necessity Patient Grievances and Appeals Patient Safety Pharmacy Pharmacology Physician Burnout Physician Credentiali...

Internal Medicine, Hospitalist - Independent medical examiner, medical bariatrics, medical billing, Diabetes, Hipaa, hospice and palliative care, HMO, life care planning, long term care, medical billing and coding, medical management, obesity, preventive medicine, urgent care