13 Payor Expert Witnesses Found

HIPAA, Medical Billing - Medical billing, Patents trade secrets, electronic medical records, Medicare fraud, medical billing fraud, qui tam false claims act fraud Usual Customary Reasonable (UCR), Meaningful Use Electronic Health Records, HITECH Act, Affordable Care Act, Medicare Advantage, Medicaid,insurance, CRPS, EMTALA

...• Medicare Secondary Payor Act, Physician-Hospital Contracts, Valuation, Health IT businesses, FQHC, ASC, ESRD, EMTALA. Claims processing, Independent Diagnostic Testing Facility (IDTF) coverage determinations, lien, balance billing subrogation, clinical documentation, billing, audits, fraud, waste abuse (E&M, orthopedics, cardiology, vascular, MRI, PET, pathology, ESRD tests, esoteric test, nephrology, diabetes). Payor contracting, arbitration, third party liability. Day global period surgical period • ERISA self-insured plan regulations including cost sharing, full and fair review.

Orthopedic Surgery, Medical Devices - Total Knee Replacement, Total Hip Replacement, Robotic-Assisted Total Joint Replacement, Digital Therapeutics, Stem Cell Therapy, Cellular Therapeutics, Molecular Biology, Platelet Rich Plasma therapy, Immunomodulators

Have co-founded companies in orthopaedic surgery, ambulatory surgery centers, digital therapeutics, home healthcare, payor models and algorithmic healthcare. Have advised for companies in robotic-assisted surgery research and development. Have written algorithmic based treatment algorithms in machine code. Experience in bench research methods and protocols, quality assurance, inspection and federal requirements, legal and regulatory issues....

Legal - Attorney Fee Dispute, Legal Fee Dispute, Legal Billings, Legal Fee Consultant, Fee Review, Legal Billing Review, Legal Fee Review, Legal Fee Auditing, Fee Litigation, Legal Fee Expert, Attorney Fee Expert, Fee Shifting,

...First as an Assistant United States Attorney, and later representing county and municipal governments, O’Connor has represented potential fee payors under “fee shifting” statutes. He, as well, has worked extensively for fee petitioners. As a private lawyer for federal government agencies during the financial institutions crises of the 1980’s and 90’s, and as well working with a variety of insurers and self-insurers, O’Connor has worked to develop with the client, and implement on behalf of his law firm, sophisticated billing guidelines. O’Connor has worked with many clients in mutually cooperative fashion to examine firm billings, assure compliance and rectify short comings. Since the advent in the late 1980’s of adversarial legal auditing, O’Connor has served extensively as both an expert and litigator analyzing audit criticisms, applying community standards, and construing applicable case law....

HIPAA, Medical Billing - Medical billing, Patents trade secrets, electronic medical records, Medicare fraud, medical billing fraud, qui tam false claims act fraud Usual Customary Reasonable (UCR), Meaningful Use Electronic Health Records, HITECH Act, Affordable Care Act, Medicare Advantage, Medicaid,insurance, CRPS, EMTALA

...• Medicare Secondary Payor Act, Physician-Hospital Contracts, Valuation, Health IT businesses, FQHC, ASC, ESRD, EMTALA. Claims processing, Independent Diagnostic Testing Facility (IDTF) coverage determinations, lien, balance billing subrogation, clinical documentation, billing, audits, fraud, waste abuse (E&M, orthopedics, cardiology, vascular, MRI, PET, pathology, ESRD tests, esoteric test, nephrology, diabetes). Payor contracting, arbitration, third party liability. Day global period surgical period • ERISA self-insured plan regulations including cost sharing, full and fair review.

HIPAA, Medical Billing - Medical billing, Patents trade secrets, electronic medical records, Medicare fraud, medical billing fraud, qui tam false claims act fraud Usual Customary Reasonable (UCR), Meaningful Use Electronic Health Records, HITECH Act, Affordable Care Act, Medicare Advantage, Medicaid,insurance, CRPS, EMTALA

...• Medicare Secondary Payor Act, Physician-Hospital Contracts, Valuation, Health IT businesses, FQHC, ASC, ESRD, EMTALA. Claims processing, Independent Diagnostic Testing Facility (IDTF) coverage determinations, lien, balance billing subrogation, clinical documentation, billing, audits, fraud, waste abuse (E&M, orthopedics, cardiology, vascular, MRI, PET, pathology, ESRD tests, esoteric test, nephrology, diabetes). Payor contracting, arbitration, third party liability. Day global period surgical period • ERISA self-insured plan regulations including cost sharing, full and fair review.

HIPAA, Medical Billing - Medical billing, Patents trade secrets, electronic medical records, Medicare fraud, medical billing fraud, qui tam false claims act fraud Usual Customary Reasonable (UCR), Meaningful Use Electronic Health Records, HITECH Act, Affordable Care Act, Medicare Advantage, Medicaid,insurance, CRPS, EMTALA

...• Medicare Secondary Payor Act, Physician-Hospital Contracts, Valuation, Health IT businesses, FQHC, ASC, ESRD, EMTALA. Claims processing, Independent Diagnostic Testing Facility (IDTF) coverage determinations, lien, balance billing subrogation, clinical documentation, billing, audits, fraud, waste abuse (E&M, orthopedics, cardiology, vascular, MRI, PET, pathology, ESRD tests, esoteric test, nephrology, diabetes). Payor contracting, arbitration, third party liability. Day global period surgical period • ERISA self-insured plan regulations including cost sharing, full and fair review.

HIPAA, Medical Billing - Medical billing, Patents trade secrets, electronic medical records, Medicare fraud, medical billing fraud, qui tam false claims act fraud Usual Customary Reasonable (UCR), Meaningful Use Electronic Health Records, HITECH Act, Affordable Care Act, Medicare Advantage, Medicaid,insurance, CRPS, EMTALA

...• Medicare Secondary Payor Act, Physician-Hospital Contracts, Valuation, Health IT businesses, FQHC, ASC, ESRD, EMTALA. Claims processing, Independent Diagnostic Testing Facility (IDTF) coverage determinations, lien, balance billing subrogation, clinical documentation, billing, audits, fraud, waste abuse (E&M, orthopedics, cardiology, vascular, MRI, PET, pathology, ESRD tests, esoteric test, nephrology, diabetes). Payor contracting, arbitration, third party liability. Day global period surgical period • ERISA self-insured plan regulations including cost sharing, full and fair review.

HIPAA, Medical Billing - Medical billing, Patents trade secrets, electronic medical records, Medicare fraud, medical billing fraud, qui tam false claims act fraud Usual Customary Reasonable (UCR), Meaningful Use Electronic Health Records, HITECH Act, Affordable Care Act, Medicare Advantage, Medicaid,insurance, CRPS, EMTALA

...• Medicare Secondary Payor Act, Physician-Hospital Contracts, Valuation, Health IT businesses, FQHC, ASC, ESRD, EMTALA. Claims processing, Independent Diagnostic Testing Facility (IDTF) coverage determinations, lien, balance billing subrogation, clinical documentation, billing, audits, fraud, waste abuse (E&M, orthopedics, cardiology, vascular, MRI, PET, pathology, ESRD tests, esoteric test, nephrology, diabetes). Payor contracting, arbitration, third party liability. Day global period surgical period • ERISA self-insured plan regulations including cost sharing, full and fair review.

HIPAA, Medical Billing - Medical billing, Patents trade secrets, electronic medical records, Medicare fraud, medical billing fraud, qui tam false claims act fraud Usual Customary Reasonable (UCR), Meaningful Use Electronic Health Records, HITECH Act, Affordable Care Act, Medicare Advantage, Medicaid,insurance, CRPS, EMTALA

...• Medicare Secondary Payor Act, Physician-Hospital Contracts, Valuation, Health IT businesses, FQHC, ASC, ESRD, EMTALA. Claims processing, Independent Diagnostic Testing Facility (IDTF) coverage determinations, lien, balance billing subrogation, clinical documentation, billing, audits, fraud, waste abuse (E&M, orthopedics, cardiology, vascular, MRI, PET, pathology, ESRD tests, esoteric test, nephrology, diabetes). Payor contracting, arbitration, third party liability. Day global period surgical period • ERISA self-insured plan regulations including cost sharing, full and fair review.

HIPAA, Medical Billing - Medical billing, Patents trade secrets, electronic medical records, Medicare fraud, medical billing fraud, qui tam false claims act fraud Usual Customary Reasonable (UCR), Meaningful Use Electronic Health Records, HITECH Act, Affordable Care Act, Medicare Advantage, Medicaid,insurance, CRPS, EMTALA

...• Medicare Secondary Payor Act, Physician-Hospital Contracts, Valuation, Health IT businesses, FQHC, ASC, ESRD, EMTALA. Claims processing, Independent Diagnostic Testing Facility (IDTF) coverage determinations, lien, balance billing subrogation, clinical documentation, billing, audits, fraud, waste abuse (E&M, orthopedics, cardiology, vascular, MRI, PET, pathology, ESRD tests, esoteric test, nephrology, diabetes). Payor contracting, arbitration, third party liability. Day global period surgical period • ERISA self-insured plan regulations including cost sharing, full and fair review.

HIPAA, Medical Billing - Medical billing, Patents trade secrets, electronic medical records, Medicare fraud, medical billing fraud, qui tam false claims act fraud Usual Customary Reasonable (UCR), Meaningful Use Electronic Health Records, HITECH Act, Affordable Care Act, Medicare Advantage, Medicaid,insurance, CRPS, EMTALA

...• Medicare Secondary Payor Act, Physician-Hospital Contracts, Valuation, Health IT businesses, FQHC, ASC, ESRD, EMTALA. Claims processing, Independent Diagnostic Testing Facility (IDTF) coverage determinations, lien, balance billing subrogation, clinical documentation, billing, audits, fraud, waste abuse (E&M, orthopedics, cardiology, vascular, MRI, PET, pathology, ESRD tests, esoteric test, nephrology, diabetes). Payor contracting, arbitration, third party liability. Day global period surgical period • ERISA self-insured plan regulations including cost sharing, full and fair review.

HIPAA, Medical Billing - Medical billing, Patents trade secrets, electronic medical records, Medicare fraud, medical billing fraud, qui tam false claims act fraud Usual Customary Reasonable (UCR), Meaningful Use Electronic Health Records, HITECH Act, Affordable Care Act, Medicare Advantage, Medicaid,insurance, CRPS, EMTALA

...• Medicare Secondary Payor Act, Physician-Hospital Contracts, Valuation, Health IT businesses, FQHC, ASC, ESRD, EMTALA. Claims processing, Independent Diagnostic Testing Facility (IDTF) coverage determinations, lien, balance billing subrogation, clinical documentation, billing, audits, fraud, waste abuse (E&M, orthopedics, cardiology, vascular, MRI, PET, pathology, ESRD tests, esoteric test, nephrology, diabetes). Payor contracting, arbitration, third party liability. Day global period surgical period • ERISA self-insured plan regulations including cost sharing, full and fair review.

HIPAA, Medical Billing - Medical billing, Patents trade secrets, electronic medical records, Medicare fraud, medical billing fraud, qui tam false claims act fraud Usual Customary Reasonable (UCR), Meaningful Use Electronic Health Records, HITECH Act, Affordable Care Act, Medicare Advantage, Medicaid,insurance, CRPS, EMTALA

...• Medicare Secondary Payor Act, Physician-Hospital Contracts, Valuation, Health IT businesses, FQHC, ASC, ESRD, EMTALA. Claims processing, Independent Diagnostic Testing Facility (IDTF) coverage determinations, lien, balance billing subrogation, clinical documentation, billing, audits, fraud, waste abuse (E&M, orthopedics, cardiology, vascular, MRI, PET, pathology, ESRD tests, esoteric test, nephrology, diabetes). Payor contracting, arbitration, third party liability. Day global period surgical period • ERISA self-insured plan regulations including cost sharing, full and fair review.