Medical Billing Expert Witness

HIPAA, Medical Coding - 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, MedicDamages Expert • Medical coding medical billing, claims, usual customary and reasonable, Lifecare plan rebuttal under ACA on the future cost of care, trauma 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, Pharmaceuticals, CLIA, lab, pathology billing accuracy, privacy Pain management, ketamine, spinal cord stimulators, blocks, p-stim, ane...

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...

HIPAA, Medical Coding - 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, MedicDamages Expert • Medical coding medical billing, claims, usual customary and reasonable, Lifecare plan rebuttal under ACA on the future cost of care, trauma 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, Pharmaceuticals, CLIA, lab, pathology billing accuracy, privacy Pain management, ketamine, spinal cord stimulators, blocks, p-stim, ane...

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, 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...

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 Coding - 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, MedicDamages Expert • Medical coding medical billing, claims, usual customary and reasonable, Lifecare plan rebuttal under ACA on the future cost of care, trauma 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, Pharmaceuticals, CLIA, lab, pathology billing accuracy, privacy Pain management, ketamine, spinal cord stimulators, blocks, p-stim, ane...

HIPAA, Medical Coding - 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, MedicDamages Expert • Medical coding medical billing, claims, usual customary and reasonable, Lifecare plan rebuttal under ACA on the future cost of care, trauma 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, Pharmaceuticals, CLIA, lab, pathology billing accuracy, privacy Pain management, ketamine, spinal cord stimulators, blocks, p-stim, ane...

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 Coding - 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, MedicDamages Expert • Medical coding medical billing, claims, usual customary and reasonable, Lifecare plan rebuttal under ACA on the future cost of care, trauma 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, Pharmaceuticals, CLIA, lab, pathology billing accuracy, privacy Pain management, ketamine, spinal cord stimulators, blocks, p-stim, ane...

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 Coding - 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, MedicDamages Expert • Medical coding medical billing, claims, usual customary and reasonable, Lifecare plan rebuttal under ACA on the future cost of care, trauma 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, Pharmaceuticals, CLIA, lab, pathology billing accuracy, privacy Pain management, ketamine, spinal cord stimulators, blocks, p-stim, ane...

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 Coding - 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, MedicDamages Expert • Medical coding medical billing, claims, usual customary and reasonable, Lifecare plan rebuttal under ACA on the future cost of care, trauma 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, Pharmaceuticals, CLIA, lab, pathology billing accuracy, privacy Pain management, ketamine, spinal cord stimulators, blocks, p-stim, ane...

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 Coding - 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, MedicDamages Expert • Medical coding medical billing, claims, usual customary and reasonable, Lifecare plan rebuttal under ACA on the future cost of care, trauma 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, Pharmaceuticals, CLIA, lab, pathology billing accuracy, privacy Pain management, ketamine, spinal cord stimulators, blocks, p-stim, ane...

HIPAA, Medical Coding - 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, MedicDamages Expert • Medical coding medical billing, claims, usual customary and reasonable, Lifecare plan rebuttal under ACA on the future cost of care, trauma 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, Pharmaceuticals, CLIA, lab, pathology billing accuracy, privacy Pain management, ketamine, spinal cord stimulators, blocks, p-stim, ane...

HIPAA, Medical Coding - 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, MedicDamages Expert • Medical coding medical billing, claims, usual customary and reasonable, Lifecare plan rebuttal under ACA on the future cost of care, trauma 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, Pharmaceuticals, CLIA, lab, pathology billing accuracy, privacy Pain management, ketamine, spinal cord stimulators, blocks, p-stim, ane...

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...

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 Coding - 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, MedicDamages Expert • Medical coding medical billing, claims, usual customary and reasonable, Lifecare plan rebuttal under ACA on the future cost of care, trauma 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, Pharmaceuticals, CLIA, lab, pathology billing accuracy, privacy Pain management, ketamine, spinal cord stimulators, blocks, p-stim, ane...

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

Medical Coding, Business Operations - Risk Adjustment, HCC, Part C, Part D, RADV, HRADV, Medicare Advantage, ACA, Affordable Care Act, Medicare fraud, medical record review, clinical bioethics, medical management, compliance, clinical documentation, clinical informatics, coding audit, medical billing, ICD-9, ICD-10, OIG audits

Clinician, Author, Speaker, Educator, USAF veteran. Author of the CRC (certified risk adjustment coder) credential curriculum - offered nationally by the AAPC. National Risk Adjustment expertise working with Medicare, Medicaid, and the Affordable Care Act (ACA) models nationally. Support for health plans, ACO's, and physicians in numerous medical coding and documentation audits. Experience working on national cases before the OIG and DOJ. National independent validation auditor (IVA) for many health plans for government regulatory audits for Medicare Advantage Risk Adjustment Data Validation (RADV) , and the ACA (HRADV). Experience in HEDIS and other quality measure programs. Experience in CLIA and OSHA in healthcare settings- especially CLIA-waived testing performed in outpatient settings. Trained in Total Quality Management (USAF) and Six Sigma (Juran Institute). Former ethics participant on internal review board (IRB) for local hospital system. Experience managing p...

HIPAA, Medical Coding - 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, MedicDamages Expert • Medical coding medical billing, claims, usual customary and reasonable, Lifecare plan rebuttal under ACA on the future cost of care, trauma 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, Pharmaceuticals, CLIA, lab, pathology billing accuracy, privacy Pain management, ketamine, spinal cord stimulators, blocks, p-stim, ane...

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...