Managed Care Expert Witnesses

Managed care 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 managed care. The managed care expert witness listings on this page are typically from fields/areas of expertise such as: Behavioral and Social Sciences, Insurance, Long Term Care, and Medical Management.

Vera Dvorak, MD TD&P Consulting Inc.

Silver Spring, Maryland
Medical Management, Long Term Care - Home Healthcare, Managed Care, Transitional Care Management, Medical Necessity Determination, Long-Term Care Planning, Evidence-Based Care Guidelines Expert, Patient-Centered Care Expert, Geriatric Services, Utilization Review, Medical Valuation, Infectious Disease
Vera Dvorak, MD, has broad and extensive experience in a continuum of care, with over 40 years working in diverse healthcare settings including home health services, palliative care, and hospice. She has also served as medical director in all of these areas. Dr. Dvorak has been a practicing physician, a managed care executive, a strategic member of corporate leadership, and vice president and medical director of hospital-based care coordination. She has been in charge of the appeals department in various managed care organizations; and is the founder of transitional care management for one of the largest healthcare systems in Northern Virginia. Dr. Dvorak’s focus has been on medical necessity determination, appropriate discharge disposition with defined short and long-term care needs. She has been a proponent of consistently applying evidence-based care guidelines to support clinical decision-making on a case-by-case basis and across the continuum of care to maximize the potenti...

J. Harold Berberick, EdD Behavioral Health Strategies, Inc.

Foxboro, Massachusetts
Behavioral and Social Sciences - Developmental Disabilities, Mental Retardation, Behavioral Health, Outpatient Mental Health, Inpatient Mental Health, Group Homes, Residential Treatment, Mental Health Standards of Care, Health Maintence Organizations, Mental Health Malpractice, Mental Health Wrongful Death, Managed Care
Dr. Berberick is Board Certified in Health Care Management. He has over 35 years of experience as a Sr. Manager in the fields of Mental Health, Community Mental Health, Managed Care and Mental Retardation. He has managed large systems of care and his expertise is especially in inpatient and outpatient treatment and all forms of mental health treatment in community settings.

Frank L Brown, Jr, MD, FACP, FRSM, FCP(E)

Bluffton, South Carolina
Medical Management, Insurance - Accountable Care Organizations, ACO, Health Insurance, Managed Care, Grievances, Peer Review, Pharmacology, Provider Credentialing, Medical Necessity, Medicare, Medicaid, Formulary, Healthcare Fraud & Abuse, Medical Billing, Medical Utilization, Utilization Review, Health Plan Benefits, Qui Tam
Senior physician executive in the health insurance industry. Certified as Health Insurance Executive. National insurance companies worked for include Oxford Healthplans, Blue Cross & Blue Shield, Wellpoint, Anthem, and Cigna. Responsibilities have included case management, fraud and abuse, physician credentialing, peer review, physician grievances & appeals, patient grievance & appeals, and patient safety. Board certified in both internal medicine, and emergency medicine. Holder of multiple patents. Experienced public speaker. Chief Medical Correspondent WVGB-FM in Beaufort, South Carolina. Yale educated, NIH trained. Conducted over 5,000 physician credentialing reviews; over 5,000 medical necessity/utilization management reviews; patient & physician appeals, & hearings; and over 2,000 committee and in-person patient grievance & appeal reviews. Served as an Examiner for the Malcolm Baldrige National Quality Award, as well as the National Committee for Quality Assurance.