HMO Expert Witnesses

San Marino, California

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...

Bluffton, South Carolina

HMO, Medical Management - Workplace Discrimination, HMO & Managed Care, Appeals & Grievances, Hospital & Provider Credentialing, Utilization/Medical Necessity, Healthcare Fraud/Abuse, Utilization Review, Physician Defamation, Quality & Patient Safety, Physician Sanctions, Medical Management, Disease Management, Privileging

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...