Inpatient Authorization Expert Witnesses
Inpatient authorization expert witnesses and consultants listed here may be able to form expert opinions, draft expert witness reports, provide expert witness testimony at deposition and/or trial as or serve as consulting (non-testifying) experts on inpatient authorization. The inpatient authorization expert witness listings on this page are typically from fields/areas of expertise such as: HMO and Insurance.
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James J. McCormick, M.D., M.B.A
Medicare Advantage Prior Auth Physician Expert
Yanceyville, North Carolina
HMO, Insurance
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prior authorization, PA, Medicare Advantage, MA, Outpatient authorization, Inpatient authorization, Post Acute authorization, Appeals, documentation standards, managed care, helicopter transportation
As a physician leader, I have designed and implemented systems to ensure medical recordkeeping meet legal, reimbursement, and quality benchmarks. I spearheaded the development of a multi-state governance framework for both primary and specialty care groups, ensuring peer review, credentialing, quality assurance, and utilization management processes are rigorously structured and defensible. I also led the creation of an enterprise-wide Utilization Management Committee to meet CMS mandates. The committee is empowered to critically evaluate national clinical policies before adoption—aligning frontline utilization decisions with evidence-based standards. With decades of expanding leadership across diverse healthcare sectors, I bring a fair, balanced, and meticulously documented expert perspective to every case I consider.
Tradewinds Healthcare Consulting, LLC 04/2025 - Present
- Consulting Expert
- Testifying Expert
- Clinical case review
Humana, Inc. 08/2023 - 04/2024...
