Medical Billing Expert Witnesses

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

Writer, speaker, published peer-reviewed works as an expert in the field recent Federal court rulings as a qualified expert published in Westlaw • US COURT OF APPEALS considered expert opinions, VACATED AND REMANDED • Two DOJ retentions, $155 million settlement • Healthcare IT patents intellectual property Technical Expert, Medicare Damages Expert • Medical coding medical billing, claims, usual customary and reasonable charges in personal injury and medical malpractice cases, Lifecare plan rebuttal under ACA on the future cost of care, trauma • Electronic medical record forensics / electronic health record forensics, E.H.R, practice management IT, medical, prescription charges, workman's compensation, insurance fraud • HIPAA Privacy, Security, Blockchain special studies MIT • Affordable Care Act, HITECH Act, electronic medical records, meaningful use, patents, and intellectual property in heal Health Risk Assessments, Risk Adjustment, HCC Medicare Part C Accountable Care • PBMs...

Medical Billing, Medical Management - Hospital Administration, Facility Operations, Healthcare Real Estate Development, Physician Recruitment

Matthew Thomas Lemak is the Chairman and Chief Executive Officer of Merem Capital & Merem Health. Merem Capital (“Merem”) is the family office of the Lemak Family of Birmingham, Alabama. Through its management team, Merem makes control investments in healthcare focused delivery, services, and clinical companies as well as real estate investments in the Southeastern United States. In general, Merem’s control investments are between $1 million and $3 million. Merem’s leadership team have a strong track record of successfully growing existing companies and creating companies where we see an unmet market need. Unlike a traditional private equity firm, as a family office Merem has an indefinite hold period and an interest in working with companies that will contribute to the communities in which we live and work. A Birmingham, Alabama native, Matthew attended Samford University for his undergraduate studies, completed his post graduate work at the Wharton School at the University ...

Medical Coding, Medical Billing - Forensic Medical Coder / Biller - UCR Certified Fraud Examiner CFE, Certified Healthcare Compliance CHC, Certified Professional Coder / Certified Instructor, Certified in Medical Reimbursement and Billing, Registered Health Info. Admin.- Medical Documentation Specialist, HIPAA, FCA

Published author and national speaker on the topic of Medical Coding, Healthcare Compliance and Healthcare Fraud; Co-Contributor of the AAPC Certified Professional Compliance Officer curriculum; Co-Author and Presenter of the CMS / OIG presentation: ACA Provider Compliance Programs - Getting Started Webinar; Assisted AZ to identify (they recouped $35 Mil) largest Healthcare Fraud in AZ history; Previous job roles included: Director of Compliance for largest provider group in AZ; Medical Coding Manager, Reimbursement Manager and Compliance Liaison for University Physician Group - Department of Medicine; Corporate Responsibility Auditor for a large 3 Hospital network; Medium and Small Practice Administrator; Professor and Instructor in the area of Medical Coding, Billing, Health Information Management and Healthcare Fraud; Professor and Curriculum Designer / Instructor for Medical Coding, Billing, Compliance and Fraud courses. Provider Educator - Medical Billing, Coding - Cons...

Life Care Planning, Medical Billing - Rehabilitation Nursing, Nursing Assessment, Case Management, Benefit Administration, Special Needs Trust, Care Coordination, Spinal Cord Injury, Traumatic Brain Injury, Cerebral Palsy, Neuromuscular Disorders, Amputation, Education, Accessibility, Medical Billing

50 years of experience in rehabilitation nursing, providing patient care, education and coordination of services. 35 years as an independent case manager working with catastrophically injured. Evaluated patients, assisted physicians in planning and coordinating the rehabilitation needs of patients with spinal cord, brain injuries, stroke and neuromuscular illnesses. Prior to founding RCC she was the Director of Physical Rehabilitation Nursing at Grossmont Hospital in San Diego, Rehabilitation Nurse Coordinator at Methodist Hospital in Indianapolis and Rehab Nursing Workshop Coordinator at Ohio State University. Doreen is currently an Adjunct Professor with San Diego State’s School of Nursing as well as a former board member of the Brain Injury Association of California (BIACAL), the San Diego Brain Injury Foundation (SDBIF) and Jewish Family Services of San Diego. In 1989, Doreen Casuto decided to start a small company with a unique goal. Doreen had recently left Grossmont Hospit...

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

Writer, speaker, published peer-reviewed works as an expert in the field recent Federal court rulings as a qualified expert published in Westlaw • US COURT OF APPEALS considered expert opinions, VACATED AND REMANDED • Two DOJ retentions, $155 million settlement • Healthcare IT patents intellectual property Technical Expert, Medicare Damages Expert • Medical coding medical billing, claims, usual customary and reasonable charges in personal injury and medical malpractice cases, Lifecare plan rebuttal under ACA on the future cost of care, trauma • Electronic medical record forensics / electronic health record forensics, E.H.R, practice management IT, medical, prescription charges, workman's compensation, insurance fraud • HIPAA Privacy, Security, Blockchain special studies MIT • Affordable Care Act, HITECH Act, electronic medical records, meaningful use, patents, and intellectual property in heal Health Risk Assessments, Risk Adjustment, HCC Medicare Part C Accountable Care • PBMs...

Medical Coding, Medical Billing - Forensic Medical Coder / Biller - UCR Certified Fraud Examiner CFE, Certified Healthcare Compliance CHC, Certified Professional Coder / Certified Instructor, Certified in Medical Reimbursement and Billing, Registered Health Info. Admin.- Medical Documentation Specialist, HIPAA, FCA

Published author and national speaker on the topic of Medical Coding, Healthcare Compliance and Healthcare Fraud; Co-Contributor of the AAPC Certified Professional Compliance Officer curriculum; Co-Author and Presenter of the CMS / OIG presentation: ACA Provider Compliance Programs - Getting Started Webinar; Assisted AZ to identify (they recouped $35 Mil) largest Healthcare Fraud in AZ history; Previous job roles included: Director of Compliance for largest provider group in AZ; Medical Coding Manager, Reimbursement Manager and Compliance Liaison for University Physician Group - Department of Medicine; Corporate Responsibility Auditor for a large 3 Hospital network; Medium and Small Practice Administrator; Professor and Instructor in the area of Medical Coding, Billing, Health Information Management and Healthcare Fraud; Professor and Curriculum Designer / Instructor for Medical Coding, Billing, Compliance and Fraud courses. Provider Educator - Medical Billing, Coding - Cons...

Life Care Planning, Medical Billing - Rehabilitation Nursing, Nursing Assessment, Case Management, Benefit Administration, Special Needs Trust, Care Coordination, Spinal Cord Injury, Traumatic Brain Injury, Cerebral Palsy, Neuromuscular Disorders, Amputation, Education, Accessibility, Medical Billing

50 years of experience in rehabilitation nursing, providing patient care, education and coordination of services. 35 years as an independent case manager working with catastrophically injured. Evaluated patients, assisted physicians in planning and coordinating the rehabilitation needs of patients with spinal cord, brain injuries, stroke and neuromuscular illnesses. Prior to founding RCC she was the Director of Physical Rehabilitation Nursing at Grossmont Hospital in San Diego, Rehabilitation Nurse Coordinator at Methodist Hospital in Indianapolis and Rehab Nursing Workshop Coordinator at Ohio State University. Doreen is currently an Adjunct Professor with San Diego State’s School of Nursing as well as a former board member of the Brain Injury Association of California (BIACAL), the San Diego Brain Injury Foundation (SDBIF) and Jewish Family Services of San Diego. In 1989, Doreen Casuto decided to start a small company with a unique goal. Doreen had recently left Grossmont Hospit...

Life Care Planning, Internal Medicine - medical billing, life care planner, hospitalist, medical devices, medical management, medical coding, legal medicine, legal nurse consulting, nurse practitioner, obstetrics and gynecology, addiction medicine, family medicine, general practice, gynecology, consultative examinations

The California Life Care Planning Association was created by experts in the field of Life Care Planning, with more than 30 years of experience working in the health care industry. All of our professionals are Certified Life Care Planners, as well as active medical practitioners dedicated to assessing lifetime cost of care for individuals with catastrophic injuries/illness. What sets us apart from many other Life Care Planning organizations and individuals is that all of our Life Care Planners have active direct experience with patient care. We hold ourselves to a higher standard and hold all of our affiliates to that same higher standard. Whether it be plaintiff, defense , or any other client, our methodology is transparent and consistent. Given the healthcare backgrounds of our founders, all Life Care Plans and services are overseen by a Physician. Similar to a hospital setting, many of our services go through "rounding" with senior partners and physicians to make sure we are keep...

Critical Care Medicine, Brain Injury Medicine - Nurse, Nurse practitioner, Neurology, Neurocritical care, Neuro pathophysiology, Palliative and Hospice care, Organ Donation, Postoperative Acute care (PACU), Medical Management, Pain management, Delirium, Acute/chronic Stroke care, Seizures, Infection control, Sepsis, Medical Billing, ACLS

I am a California Registered Nurse and Nurse Practitioner with 18 years of experience in critical care medicine. During my professional career I have experience in neurologic/surgical/trauma intensive care units (ICU) and postoperative anesthesia care units (PACU). My ICU experience has fine-tuned the ability to connect with families/patients/medical personnel and has optimized my critical thinking and decision-making process under stressful and chaotic circumstances. I also have 8 years of experience as an organ procurement coordinator, during which time I've had the privilege of presenting at national level conventions and community events. My audience included doctors, nurses, college students and general interested parties. The past 7 years I have practiced as a Nurse Practitioner (NP) in the ICU. We are the only Comprehensive Stroke Certified hospital in our county providing world renown care to patients with neurologic and cardiovascular illnesses. This experience has le...

Pain Management - Medicine, Physical Medicine & Rehab - Spinal Cord Stimulator, Opioid, Facet, Epidural, Pill Mill, Complex Regional Pain Syndrome, CRPS, Opioid Overdose, Radiofrequency Ablation, Medical Necessity, Medical Billing, Independent Medical Examination, IME, spinal cord injury, neuromodulation, fluoroscopy, fraud, platelet rich plasma

Double-board certified physician (physical medicine & rehabilitation and pain medicine). Full-time clinical practice. Assistant professor, Loma Linda University School of Medicine. Experienced expert witness and independent medical examiner – has reviewed over one hundred cases and testified at deposition on numerous occasions.

Medical Coding, Medical Billing - CPT codes,Bill & Coding,Compliance,Accounts Receivable Reduction,Bill Review,Personal Injury Bill Reduction,Attorney education on consumers have rights too, Bill Analaysis, UCR pricing.

Beth Morgan, President & CEO, is a Certified Professional Coder (CPC) and Compliance Specialist (MCS-P) since 2004. Over the past 20 years she has worked in several areas of the medical profession doing billing and coding for all sorts of providers. Her knowledge and expertise has enabled her to not only reduce provider’s accounts receivables but medical bills by 51%. She has access to a broad base of insurance company policy information, and is an information contributor, to radio and TV shows as well as magazine articles. Medical Bill Detectives reviews medical bills for errors and overcharges, reducing them down to Usual Reasonable and Customary charges and negotiating discounts for the uninsured and underinsured.

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

Writer, speaker, published peer-reviewed works as an expert in the field recent Federal court rulings as a qualified expert published in Westlaw • US COURT OF APPEALS considered expert opinions, VACATED AND REMANDED • Two DOJ retentions, $155 million settlement • Healthcare IT patents intellectual property Technical Expert, Medicare Damages Expert • Medical coding medical billing, claims, usual customary and reasonable charges in personal injury and medical malpractice cases, Lifecare plan rebuttal under ACA on the future cost of care, trauma • Electronic medical record forensics / electronic health record forensics, E.H.R, practice management IT, medical, prescription charges, workman's compensation, insurance fraud • HIPAA Privacy, Security, Blockchain special studies MIT • Affordable Care Act, HITECH Act, electronic medical records, meaningful use, patents, and intellectual property in heal Health Risk Assessments, Risk Adjustment, HCC Medicare Part C Accountable Care • PBMs...

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

Writer, speaker, published peer-reviewed works as an expert in the field recent Federal court rulings as a qualified expert published in Westlaw • US COURT OF APPEALS considered expert opinions, VACATED AND REMANDED • Two DOJ retentions, $155 million settlement • Healthcare IT patents intellectual property Technical Expert, Medicare Damages Expert • Medical coding medical billing, claims, usual customary and reasonable charges in personal injury and medical malpractice cases, Lifecare plan rebuttal under ACA on the future cost of care, trauma • Electronic medical record forensics / electronic health record forensics, E.H.R, practice management IT, medical, prescription charges, workman's compensation, insurance fraud • HIPAA Privacy, Security, Blockchain special studies MIT • Affordable Care Act, HITECH Act, electronic medical records, meaningful use, patents, and intellectual property in heal Health Risk Assessments, Risk Adjustment, HCC Medicare Part C Accountable Care • PBMs...

Medical Coding, Medical Billing

Ronda K. Ash, CPC, CPMA, CHC, CIFHA is the President of RKAsh Consulting Associates, Inc., a healthcare consulting firm focusing on compliance, procedural and diagnosis coding, documentation education, auditing, and expert testimony. Ms. Ash embarked on her career in the medical coding arena for an Emergency Department more than 20 years ago. She quickly excelled due to her attention to detail and her commitment to quality, earning her a reputation as an industry leader. As such, she has been sought out as a key component in revenue optimization by physician groups and healthcare organizations as well as serving as an expert witness in the field of Medical Coding.

Hospitalist, Medical Billing - disability, Diabetes, congestive heart failure, Kidney Disease, Sepsis, Stroke, COPD/Asthma, Medication Errors, COVID-19, coronavirus, pressure sores, wound care, DVT, deep vein thrombosis, handoffs, medical necessity, healthcare fraud, telemedicine

Board-Certified Internal Medicine Physician with 10+ years experience as a Hospitalist & Telemedicine Hospitalist. Active clinical practice. Significant experience drafting medico-legal reports and providing medical necessity and disability opinions. Additional conditions commonly treated include: electrolyte abnormalities, hypertension, heart disease, congestive heart failure, cardiac arrhythmias, acute respiratory failure, sepsis, stroke , medication errors, deep vein thrombosis, skin and soft skin infections, delirium, cirrhosis, gastrointestinal bleed, and Covid -19 complications.

Hospitalist, Medical Billing - Internal Medicine, PE, Pulmonary Embolism, Pneumonia, COVID-19, infection, pressure sores, decubitus ulcers, medical necessity, healthcare fraud, qui tam, sepsis, falls, stroke, DVT, Deep Vein Thrombosis, hypoglycemia, hand offs, Nurse Practitioner & PA Supervision, Disability Evaluation, bleeds

Cleveland Clinic trained hospitalist in active clinical practice. Board certified in internal medicine with a practice focus on hospital medicine. 20+ years of clinical experience. Experienced expert witness at both deposition and trial. Vast medical necessity, UR (utilization review) and disability file review experience – has reviewed in excess of 2,000 charts. Conducted over 1,700 Veterans Benefits Administration (VBA) Disability Reviews. Also experienced in UDT (Urine Drug Testing Analysis) and IMEs (Independent Medical Examinations).

Psychiatry, Substance Abuse - Addiction Psychiatry, Disability Evaluation, Medical Billing, Medical Record Review, Mental Health, Psychoanalysis, Public Health, Tele-medicine, Medical Malpractice, Psychopharmacology, Utilization Review, Opioids

Dr. Maree is board certified by the American Board of Psychiatry and Neurology in General Adult Psychiatry and holds medical licenses in Georgia and Pennsylvania. She has extensive experience diagnosing and treating a variety of psychiatric disorders including trauma related disorders, mood/anxiety disorders, psychotic spectrum disorders, and dual diagnosis disorders. In addition to experience in the ambulatory/outpatient setting, she has also worked in emergency psychiatry, with intensive outpatient programs, on consultation and liaison teams, in various tele-medicine settings, and with community treatment teams. Dr. Maree also obtained additional training in Psychodynamic Psychotherapy and is currently a candidate for Psychoanalysis at Emory University, which provides her with a unique perspective in understanding and formulating a person's experiences. In addition to her clinical work, Dr. Maree has experience with peer review, utilization management, chart review, disability ...

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

Writer, speaker, published peer-reviewed works as an expert in the field recent Federal court rulings as a qualified expert published in Westlaw • US COURT OF APPEALS considered expert opinions, VACATED AND REMANDED • Two DOJ retentions, $155 million settlement • Healthcare IT patents intellectual property Technical Expert, Medicare Damages Expert • Medical coding medical billing, claims, usual customary and reasonable charges in personal injury and medical malpractice cases, Lifecare plan rebuttal under ACA on the future cost of care, trauma • Electronic medical record forensics / electronic health record forensics, E.H.R, practice management IT, medical, prescription charges, workman's compensation, insurance fraud • HIPAA Privacy, Security, Blockchain special studies MIT • Affordable Care Act, HITECH Act, electronic medical records, meaningful use, patents, and intellectual property in heal Health Risk Assessments, Risk Adjustment, HCC Medicare Part C Accountable Care • PBMs...

Pain Management - Medicine - Chronic pain, spine injections, steroid injections, opiates, CRPS, RSD, NECC, nerve injury, cauda equina, sacral fractures, failed back syndrome, facet injections, radiofrequency ablation, overdose, billing fraud, medical billing, personal injury, medical necessity

Award-Winning, Harvard Trained Pain Management Physician in active clinical practice. Tufts Faculty (2005-Present). Harvard Faculty (1997-2005). Double Board Certified (Anesthesia and Pain Management). 10+ years experience Medical Director, Tufts. Opiate Management Committee, Tufts Medical Center (2014-Present). Boston College - Scholar of the College/Gasson Scholar. Experienced expert witness at both deposition and trial. Forensic experience includes medical malpractice, workers’ compensation, criminal matters, and health care fraud

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

Writer, speaker, published peer-reviewed works as an expert in the field recent Federal court rulings as a qualified expert published in Westlaw • US COURT OF APPEALS considered expert opinions, VACATED AND REMANDED • Two DOJ retentions, $155 million settlement • Healthcare IT patents intellectual property Technical Expert, Medicare Damages Expert • Medical coding medical billing, claims, usual customary and reasonable charges in personal injury and medical malpractice cases, Lifecare plan rebuttal under ACA on the future cost of care, trauma • Electronic medical record forensics / electronic health record forensics, E.H.R, practice management IT, medical, prescription charges, workman's compensation, insurance fraud • HIPAA Privacy, Security, Blockchain special studies MIT • Affordable Care Act, HITECH Act, electronic medical records, meaningful use, patents, and intellectual property in heal Health Risk Assessments, Risk Adjustment, HCC Medicare Part C Accountable Care • PBMs...

Medical Coding, Medical Billing - Forensic Medical Coder / Biller - UCR Certified Fraud Examiner CFE, Certified Healthcare Compliance CHC, Certified Professional Coder / Certified Instructor, Certified in Medical Reimbursement and Billing, Registered Health Info. Admin.- Medical Documentation Specialist, HIPAA, FCA

Published author and national speaker on the topic of Medical Coding, Healthcare Compliance and Healthcare Fraud; Co-Contributor of the AAPC Certified Professional Compliance Officer curriculum; Co-Author and Presenter of the CMS / OIG presentation: ACA Provider Compliance Programs - Getting Started Webinar; Assisted AZ to identify (they recouped $35 Mil) largest Healthcare Fraud in AZ history; Previous job roles included: Director of Compliance for largest provider group in AZ; Medical Coding Manager, Reimbursement Manager and Compliance Liaison for University Physician Group - Department of Medicine; Corporate Responsibility Auditor for a large 3 Hospital network; Medium and Small Practice Administrator; Professor and Instructor in the area of Medical Coding, Billing, Health Information Management and Healthcare Fraud; Professor and Curriculum Designer / Instructor for Medical Coding, Billing, Compliance and Fraud courses. Provider Educator - Medical Billing, Coding - Cons...

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

Writer, speaker, published peer-reviewed works as an expert in the field recent Federal court rulings as a qualified expert published in Westlaw • US COURT OF APPEALS considered expert opinions, VACATED AND REMANDED • Two DOJ retentions, $155 million settlement • Healthcare IT patents intellectual property Technical Expert, Medicare Damages Expert • Medical coding medical billing, claims, usual customary and reasonable charges in personal injury and medical malpractice cases, Lifecare plan rebuttal under ACA on the future cost of care, trauma • Electronic medical record forensics / electronic health record forensics, E.H.R, practice management IT, medical, prescription charges, workman's compensation, insurance fraud • HIPAA Privacy, Security, Blockchain special studies MIT • Affordable Care Act, HITECH Act, electronic medical records, meaningful use, patents, and intellectual property in heal Health Risk Assessments, Risk Adjustment, HCC Medicare Part C Accountable Care • PBMs...

Medical Coding, Medical Billing - Forensic Medical Coder / Biller - UCR Certified Fraud Examiner CFE, Certified Healthcare Compliance CHC, Certified Professional Coder / Certified Instructor, Certified in Medical Reimbursement and Billing, Registered Health Info. Admin.- Medical Documentation Specialist, HIPAA, FCA

Published author and national speaker on the topic of Medical Coding, Healthcare Compliance and Healthcare Fraud; Co-Contributor of the AAPC Certified Professional Compliance Officer curriculum; Co-Author and Presenter of the CMS / OIG presentation: ACA Provider Compliance Programs - Getting Started Webinar; Assisted AZ to identify (they recouped $35 Mil) largest Healthcare Fraud in AZ history; Previous job roles included: Director of Compliance for largest provider group in AZ; Medical Coding Manager, Reimbursement Manager and Compliance Liaison for University Physician Group - Department of Medicine; Corporate Responsibility Auditor for a large 3 Hospital network; Medium and Small Practice Administrator; Professor and Instructor in the area of Medical Coding, Billing, Health Information Management and Healthcare Fraud; Professor and Curriculum Designer / Instructor for Medical Coding, Billing, Compliance and Fraud courses. Provider Educator - Medical Billing, Coding - Cons...

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

Writer, speaker, published peer-reviewed works as an expert in the field recent Federal court rulings as a qualified expert published in Westlaw • US COURT OF APPEALS considered expert opinions, VACATED AND REMANDED • Two DOJ retentions, $155 million settlement • Healthcare IT patents intellectual property Technical Expert, Medicare Damages Expert • Medical coding medical billing, claims, usual customary and reasonable charges in personal injury and medical malpractice cases, Lifecare plan rebuttal under ACA on the future cost of care, trauma • Electronic medical record forensics / electronic health record forensics, E.H.R, practice management IT, medical, prescription charges, workman's compensation, insurance fraud • HIPAA Privacy, Security, Blockchain special studies MIT • Affordable Care Act, HITECH Act, electronic medical records, meaningful use, patents, and intellectual property in heal Health Risk Assessments, Risk Adjustment, HCC Medicare Part C Accountable Care • PBMs...

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

Writer, speaker, published peer-reviewed works as an expert in the field recent Federal court rulings as a qualified expert published in Westlaw • US COURT OF APPEALS considered expert opinions, VACATED AND REMANDED • Two DOJ retentions, $155 million settlement • Healthcare IT patents intellectual property Technical Expert, Medicare Damages Expert • Medical coding medical billing, claims, usual customary and reasonable charges in personal injury and medical malpractice cases, Lifecare plan rebuttal under ACA on the future cost of care, trauma • Electronic medical record forensics / electronic health record forensics, E.H.R, practice management IT, medical, prescription charges, workman's compensation, insurance fraud • HIPAA Privacy, Security, Blockchain special studies MIT • Affordable Care Act, HITECH Act, electronic medical records, meaningful use, patents, and intellectual property in heal Health Risk Assessments, Risk Adjustment, HCC Medicare Part C Accountable Care • PBMs...

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

Writer, speaker, published peer-reviewed works as an expert in the field recent Federal court rulings as a qualified expert published in Westlaw • US COURT OF APPEALS considered expert opinions, VACATED AND REMANDED • Two DOJ retentions, $155 million settlement • Healthcare IT patents intellectual property Technical Expert, Medicare Damages Expert • Medical coding medical billing, claims, usual customary and reasonable charges in personal injury and medical malpractice cases, Lifecare plan rebuttal under ACA on the future cost of care, trauma • Electronic medical record forensics / electronic health record forensics, E.H.R, practice management IT, medical, prescription charges, workman's compensation, insurance fraud • HIPAA Privacy, Security, Blockchain special studies MIT • Affordable Care Act, HITECH Act, electronic medical records, meaningful use, patents, and intellectual property in heal Health Risk Assessments, Risk Adjustment, HCC Medicare Part C Accountable Care • PBMs...

Medical Coding, Medical Billing - Forensic Medical Coder / Biller - UCR Certified Fraud Examiner CFE, Certified Healthcare Compliance CHC, Certified Professional Coder / Certified Instructor, Certified in Medical Reimbursement and Billing, Registered Health Info. Admin.- Medical Documentation Specialist, HIPAA, FCA

Published author and national speaker on the topic of Medical Coding, Healthcare Compliance and Healthcare Fraud; Co-Contributor of the AAPC Certified Professional Compliance Officer curriculum; Co-Author and Presenter of the CMS / OIG presentation: ACA Provider Compliance Programs - Getting Started Webinar; Assisted AZ to identify (they recouped $35 Mil) largest Healthcare Fraud in AZ history; Previous job roles included: Director of Compliance for largest provider group in AZ; Medical Coding Manager, Reimbursement Manager and Compliance Liaison for University Physician Group - Department of Medicine; Corporate Responsibility Auditor for a large 3 Hospital network; Medium and Small Practice Administrator; Professor and Instructor in the area of Medical Coding, Billing, Health Information Management and Healthcare Fraud; Professor and Curriculum Designer / Instructor for Medical Coding, Billing, Compliance and Fraud courses. Provider Educator - Medical Billing, Coding - Cons...

Life Care Planning, Medical Billing - Traumatic Brain injuries, Surgical revisions, Orthopedic injuries, Chronic pain, Amputations, Burns, Electrocution, End stage renal failure, Dialysis, Spinal cord injuries, End of Life Care/Hospice, Bill Reviews, NJ PIP Law, New Jersey Haynes Decision.

Jim Quinn is a registered nurse and certified life care planner who has been elected to and currently serves on the executive board of The American Association of Nurse Life Care Planners as the Treasurer. He is an experienced life care planner, having developed over 500 reports including life care plans, cost projections, rebuttals, and bill reviews. His life care planning background has had particular focus on accepted costing and coding methodologies. He has received coding training through the American Academy of Professional Coders, and he has demonstrated his expertise in the field of medical billing and coding by having successfully passed the Certified Professional Biller examination through the AAPC. His bill review practice has had significant focus in New Jersey matters, including pre and post Haines decision, as well as NJ PIP Law. Jim has extensive clinical experience having cared for patients in various life stages from infant to geriatric, and from the emergency room...

Medical Billing, Insurance - ACO, Health Insurance, Managed Care, Grievances, Peer Review, Pharmacology, Provider Credentialing, Medical Management, Medical Necessity, Medicare, Medicaid, Formulary, Healthcare Fraud & Abuse, Medical Billing & Coding, Medical Utilization, Utilization Review, Health Plan Benefits, Qui Tam.

Senior physician executive in the health insurance industry, with licensure in Kentucky, North Carolina, Pennsylvania, and Virginia. 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...

Medical Billing, Medical Coding - Qui Tam, Health Insurance Fraud, Health Insurance Abuse, Medicare, Medicare Fraud, Medicare Abuse, Medical Policy, Medical Necessity in Medicare, Medicare LCDs, Medicare NCDs, Medicare Coding, Medicare Billing, Health Insurance Coding, Upcoding, Medical Devices, New Medical Technology

Completed SEAK Expert Witness Training. Experience working on 4 large qui tam cases. Retired Captain (O-6) United States Navy. Board Certified General Surgeon. Partner in Healthcare Compliance Management, LLC, a consulting firm incorporated in Texas. Dr. Alexander and his partners established HCM in early 2002 and since that time he has been involved in numerous healthcare compliance consulting projects for major pharmaceutical and medical device manufacturers, large and small hospitals, cancer centers, large and small physician groups, other consulting entities as a special consultant, and legal firms (both as a consultant and as an expert witness).

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

Writer, speaker, published peer-reviewed works as an expert in the field recent Federal court rulings as a qualified expert published in Westlaw • US COURT OF APPEALS considered expert opinions, VACATED AND REMANDED • Two DOJ retentions, $155 million settlement • Healthcare IT patents intellectual property Technical Expert, Medicare Damages Expert • Medical coding medical billing, claims, usual customary and reasonable charges in personal injury and medical malpractice cases, Lifecare plan rebuttal under ACA on the future cost of care, trauma • Electronic medical record forensics / electronic health record forensics, E.H.R, practice management IT, medical, prescription charges, workman's compensation, insurance fraud • HIPAA Privacy, Security, Blockchain special studies MIT • Affordable Care Act, HITECH Act, electronic medical records, meaningful use, patents, and intellectual property in heal Health Risk Assessments, Risk Adjustment, HCC Medicare Part C Accountable Care • PBMs...

Medical Billing, Medical Coding - Medical Bill Review, Controverting Billing Affidavits, Forensic Bill Review, Medical Cost Analysis, Expert Witness for Deposition/ Trial, Usual,Customary,Reasonable (UCR) fee analyses, Geographic Specific Provider market comparisons, Medicare, Medicaid, Major Insurance comps

Life Care Planning, Medical Billing - Rehabilitation Nursing, Nursing Assessment, Case Management, Benefit Administration, Special Needs Trust, Care Coordination, Spinal Cord Injury, Traumatic Brain Injury, Cerebral Palsy, Neuromuscular Disorders, Amputation, Education, Accessibility, Medical Billing

50 years of experience in rehabilitation nursing, providing patient care, education and coordination of services. 35 years as an independent case manager working with catastrophically injured. Evaluated patients, assisted physicians in planning and coordinating the rehabilitation needs of patients with spinal cord, brain injuries, stroke and neuromuscular illnesses. Prior to founding RCC she was the Director of Physical Rehabilitation Nursing at Grossmont Hospital in San Diego, Rehabilitation Nurse Coordinator at Methodist Hospital in Indianapolis and Rehab Nursing Workshop Coordinator at Ohio State University. Doreen is currently an Adjunct Professor with San Diego State’s School of Nursing as well as a former board member of the Brain Injury Association of California (BIACAL), the San Diego Brain Injury Foundation (SDBIF) and Jewish Family Services of San Diego. In 1989, Doreen Casuto decided to start a small company with a unique goal. Doreen had recently left Grossmont Hospit...

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

Writer, speaker, published peer-reviewed works as an expert in the field recent Federal court rulings as a qualified expert published in Westlaw • US COURT OF APPEALS considered expert opinions, VACATED AND REMANDED • Two DOJ retentions, $155 million settlement • Healthcare IT patents intellectual property Technical Expert, Medicare Damages Expert • Medical coding medical billing, claims, usual customary and reasonable charges in personal injury and medical malpractice cases, Lifecare plan rebuttal under ACA on the future cost of care, trauma • Electronic medical record forensics / electronic health record forensics, E.H.R, practice management IT, medical, prescription charges, workman's compensation, insurance fraud • HIPAA Privacy, Security, Blockchain special studies MIT • Affordable Care Act, HITECH Act, electronic medical records, meaningful use, patents, and intellectual property in heal Health Risk Assessments, Risk Adjustment, HCC Medicare Part C Accountable Care • PBMs...

Medical Coding, Medical Billing - Forensic Medical Coder / Biller - UCR Certified Fraud Examiner CFE, Certified Healthcare Compliance CHC, Certified Professional Coder / Certified Instructor, Certified in Medical Reimbursement and Billing, Registered Health Info. Admin.- Medical Documentation Specialist, HIPAA, FCA

Published author and national speaker on the topic of Medical Coding, Healthcare Compliance and Healthcare Fraud; Co-Contributor of the AAPC Certified Professional Compliance Officer curriculum; Co-Author and Presenter of the CMS / OIG presentation: ACA Provider Compliance Programs - Getting Started Webinar; Assisted AZ to identify (they recouped $35 Mil) largest Healthcare Fraud in AZ history; Previous job roles included: Director of Compliance for largest provider group in AZ; Medical Coding Manager, Reimbursement Manager and Compliance Liaison for University Physician Group - Department of Medicine; Corporate Responsibility Auditor for a large 3 Hospital network; Medium and Small Practice Administrator; Professor and Instructor in the area of Medical Coding, Billing, Health Information Management and Healthcare Fraud; Professor and Curriculum Designer / Instructor for Medical Coding, Billing, Compliance and Fraud courses. Provider Educator - Medical Billing, Coding - Cons...