DME & Wound Care Medical Necessity Expert

Specialties & Experience of this Expert Witness

Additional Information

Bryan W. Smith, DPT, MBA, brings a rare combination of clinical training, wound care program leadership, and deep regulatory/reimbursement expertise to matters involving DME and wound care medical necessity, reimbursement compliance, and workers' compensation case review. After earning his Master of Science in Physical Therapy from Texas Woman's University, Bryan began his career providing direct patient care in inpatient and outpatient rehabilitation, long-term care, and hospice settings before transitioning to a national wound care and DME provider serving over 4,600 long-term care facilities and hospice agencies nationwide, where he spent over a decade in roles of increasing responsibility — from Clinical Wound Specialist to Quality Assurance and Performance Improvement leadership. During this time, Bryan pursued and earned his Doctor of Physical Therapy from Temple University — driven by a passion for continued learning and a desire to deepen his clinical and critical thinking skills to become a more effective leader and subject matter expert in wound care and healthcare operations. In these roles, Bryan: • Authored legal briefs and provided expert witness testimony before Medicare Administrative Law Judges in Level 2 Hearings and Appeals, addressing medical necessity and reimbursement for wound care treatment protocols under Medicare Part B • Authored medical necessity appeal letters and supporting clinical documentation submitted to DMERC and other insurance carriers for wound care treatment claims • Led the Performance Improvement component of the company's national re-accreditation with the Accrediting Commission for Health Care (ACHC) • Contributed to task groups presenting revisions to Medicare's Local Coverage Determinations (LCDs) governing reimbursement for surgical dressings used in wound care Bryan went on to earn an MBA and a Six Sigma Black Belt, and spent the past several years in senior commercial operations leadership in healthcare — most recently as Vice President of Sales Operations at a national workers' compensation DME company, where he: • Led multi-state market expansion analyses across 14+ states, evaluating WC fee schedules, managed care administrator structures, and pre-authorization thresholds • Conducted HCPCS billing and reimbursement analysis across multiple billing tracks and TPA payer structures • Managed a critical DME supply chain sourcing campaign across 8+ domestic and international manufacturers, evaluating regulatory compliance and reimbursement viability He is available for record review, written reports, and consultation in matters involving: DME and wound care medical necessity; billing, coding, and reimbursement compliance; suspected fraud, waste, or abuse in DME/wound care claims; utilization review; Medicare Part B and DMERC appeals; and multi-state workers' compensation fee schedule and TPA payer structure analysis. Based in Houston, Texas; available nationwide.