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 • genetic testing, novel genetic sequencing, esoteric testing, laboratory testing • HIPAA Privacy, Security, Blockchain special studies MIT • Affordable Care Act, HITECH Act, electronic medical records, meaningful use, patents, and intellectual property in heal Healt...

Medical Billing, Medical Coding - Usual customary reasonable charges, damages, fraud, Over-billing statistical analysis, Electronic health records, clinical documentation, insurance coverage determinations, provider, biller, insurance disputes

Two decades of Medical Billing expertise in multiple care settings. 24-hour turnaround on billing consultations. Thorough analysis and reporting. Expert in analysis of contract rates compared to actual billed charges 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, HIPPA compliance

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, Accessibility, Medical Billing, Case Management, Benefit Application

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...

Spine Surgery & Spine Care, Medical Coding - Spine fusion, Spine tumors, Spine trauma, Laminectomy, Discectomy, Total disk replacement, Decompression, Dural tear, Pedicle screws, Independent medical examinations, IME, Causation, Medical coding, Medical billing, Medical necessity, Spinal abscess, Disability evaluation, Workers Comp, MVA

Board Certified in Orthopedic Surgery and Spine Surgery in active clinical practice. Fellowship trained in both spinal reconstructive surgery and musculoskeletal oncology and reconstruction. 20+ years clinical experience in spine surgery. Well-experienced public speaker. Special expertise in spinal care coding. New Mexico State Team Physician. Experienced expert witness, independent medical examiner, and medical necessity peer reviewer. Licensed in New Mexico, Texas and Arizona.

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 • genetic testing, novel genetic sequencing, esoteric testing, laboratory testing • HIPAA Privacy, Security, Blockchain special studies MIT • Affordable Care Act, HITECH Act, electronic medical records, meaningful use, patents, and intellectual property in heal Healt...

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, Accessibility, Medical Billing, Case Management, Benefit Application

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...

Nurse, Medical Management - After Hospital Care Coordination, Inpatient Care Management, Medical Chart Documentation, Medical Billing, Nurse Practice, Nursing Assessment, Benefit Administration, Benefit Application, Medical Claim Appeals, Chart Review.

Ms Moreali has enjoyed 49 years of medical experience in Nursing providing patient care covering areas in critical care, case management, education and coordination of services, medical consulting, quality and regulatory management. Expertise in chart review/ analysis and documentation. She also had 40 years expertise in independent consulting, development of disease management programs, and with inpatient care coordination teams consisting of Hospitalists, RN, RN Case Manager, and Social Services. Working with large HMO’s and singular hospital organizations.

Medical Billing, Medical Coding - Medical Billing Expert, Medical Cost Expert, Healthcare Finance, Revenue Cycle Management

EXPERIENCE: Tahoe Forest Health District, Truckee, CA: June 2018 to Present – Director, Revenue Cycle Projects Responsible for coordination of all revenue cycle functions for 2 hospitals, a cancer center, surgery center, skilled nursing facility, hospice and 150 providers in various clinics in 2 states. Provide management oversite to systems development, charge description master (Revenue Integrity), business office, health information management, patient registration, and customer service. Facility uses both EPIC Hospital Billing (HB) and EPIC Physician Billing (PB) Abacus Analytics: Revenue Analyst/Expert Witness: June 2017 to Present Working as in independent reviewer / expert witness on 3rd party liability medical cases. Principal, Independent Revenue Cycle Consultant: 1991 - Present Consulting projects involve interacting with internal staff in all facets of the revenue cycle. Typical projects include focusing on operational assessments and issues involving staff. Emphas...

Orthopedic Surgery, Sports Medicine - Hip, Knee, Shoulder, Trauma, Causation, Spine Surgery & Spine Care, Orthopedics Non Surgical, Independent Medical Examinations, IME, Life care planning, Disability evaluation, Impairment Evaluation, Medical Coding, Medical billing, Fraud, Workers’ Compensation, Motor Vehicle Accident, Patents, MVA

Board-Certified orthopedic surgeon in active clinical practice. Additional sub-specialty Certification in Sports Medicine. IME certified. Have performed over 8,000 joint replacements, hip, knee and shoulder arthroscopies and open surgeries. After developing a hand tremor, I now focus on the non-operative management of orthopedic disease and trauma. Former Team Physician for the Oakland Athletics. United States Navy veteran. I have been participating in expert witness work for 13+ years. I perform complex case reviews with or without an exam, as well as provide clarity to simpler incidents. I am timely and prioritize scheduling exams, depositions and court appearances.

Orthopedic Surgery, Orthopedics - Non-Surgical - Medical Billing, Slip, Trip & Fall, Gaming, Gambling

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 • genetic testing, novel genetic sequencing, esoteric testing, laboratory testing • HIPAA Privacy, Security, Blockchain special studies MIT • Affordable Care Act, HITECH Act, electronic medical records, meaningful use, patents, and intellectual property in heal Healt...

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 • genetic testing, novel genetic sequencing, esoteric testing, laboratory testing • HIPAA Privacy, Security, Blockchain special studies MIT • Affordable Care Act, HITECH Act, electronic medical records, meaningful use, patents, and intellectual property in heal Healt...

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 • genetic testing, novel genetic sequencing, esoteric testing, laboratory testing • HIPAA Privacy, Security, Blockchain special studies MIT • Affordable Care Act, HITECH Act, electronic medical records, meaningful use, patents, and intellectual property in heal Healt...

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 • genetic testing, novel genetic sequencing, esoteric testing, laboratory testing • HIPAA Privacy, Security, Blockchain special studies MIT • Affordable Care Act, HITECH Act, electronic medical records, meaningful use, patents, and intellectual property in heal Healt...

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

Medical Management, Hospice and Palliative Care - Hospital Corporate Negligence, Hospital Liability, Hospital administration, Hospice care, Hospice fraud, healthcare fraud, Credentialing, Policies and procedures, Mental Health, Covid, sepsis, hemorrhage, medical billing, qui tam, medical necessity, DNR, end of life, hospital advertising.

Highly experienced hospital corporate negligence, hospital credentialing and hospice expert witness. Reviewed over 800 cases and testified in 48 trials and depositions over 23 years. Trained at Dartmouth and Brown medical schools. Previous Assistant Professor appointment at Harvard Medical School. Practiced internal medicine for 24 years. Served as medical director and chief medical officer for Beth Israel Deaconess Physician Organization for 15 years in Boston. Former chief of medical services at Massachusetts Mental Health Center, Boston, MA and New England Deaconess Psychiatric unit. Former editor for Journal of the American Medical Association. Served as chief medical officer for Arcadia -- a data aggregation and analytics company providing population health services to large healthcare organizations. Currently practice in hospice for Care Dimensions hospice in Lincoln, Mass. Experienced speaker and presenter.

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 • genetic testing, novel genetic sequencing, esoteric testing, laboratory testing • HIPAA Privacy, Security, Blockchain special studies MIT • Affordable Care Act, HITECH Act, electronic medical records, meaningful use, patents, and intellectual property in heal Healt...

Medical Billing, Medical Coding - Medical Billing Expert, Medical Cost Expert, Healthcare Finance, Revenue Cycle Management

EXPERIENCE: Tahoe Forest Health District, Truckee, CA: June 2018 to Present – Director, Revenue Cycle Projects Responsible for coordination of all revenue cycle functions for 2 hospitals, a cancer center, surgery center, skilled nursing facility, hospice and 150 providers in various clinics in 2 states. Provide management oversite to systems development, charge description master (Revenue Integrity), business office, health information management, patient registration, and customer service. Facility uses both EPIC Hospital Billing (HB) and EPIC Physician Billing (PB) Abacus Analytics: Revenue Analyst/Expert Witness: June 2017 to Present Working as in independent reviewer / expert witness on 3rd party liability medical cases. Principal, Independent Revenue Cycle Consultant: 1991 - Present Consulting projects involve interacting with internal staff in all facets of the revenue cycle. Typical projects include focusing on operational assessments and issues involving staff. Emphas...

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 • genetic testing, novel genetic sequencing, esoteric testing, laboratory testing • HIPAA Privacy, Security, Blockchain special studies MIT • Affordable Care Act, HITECH Act, electronic medical records, meaningful use, patents, and intellectual property in heal Healt...

Spine Surgery & Spine Care, Medical Coding - Spine fusion, Spine tumors, Spine trauma, Laminectomy, Discectomy, Total disk replacement, Decompression, Dural tear, Pedicle screws, Independent medical examinations, IME, Causation, Medical coding, Medical billing, Medical necessity, Spinal abscess, Disability evaluation, Workers Comp, MVA

Board Certified in Orthopedic Surgery and Spine Surgery in active clinical practice. Fellowship trained in both spinal reconstructive surgery and musculoskeletal oncology and reconstruction. 20+ years clinical experience in spine surgery. Well-experienced public speaker. Special expertise in spinal care coding. New Mexico State Team Physician. Experienced expert witness, independent medical examiner, and medical necessity peer reviewer. Licensed in New Mexico, Texas and Arizona.

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 • genetic testing, novel genetic sequencing, esoteric testing, laboratory testing • HIPAA Privacy, Security, Blockchain special studies MIT • Affordable Care Act, HITECH Act, electronic medical records, meaningful use, patents, and intellectual property in heal Healt...

Pain Management - Medicine, Anesthesiology - Complex Regional Pain Syndrome, CRPS, Reflex Sympathetic Dystrophy, RSD, Nerve Injury, Nerve Pain, Failed Back, Epidural Injections, Hematoma, Chronic pain, Opioids, Pill Mills, Overprescribing, Addiction, Fraud, IME, Independent Medical examinations, Medical Billing, Medical Coding, Fibromyalgia

Dr. Adam J Carinci MD, JD, MBA is a nationally recognized and sought after clinician, speaker and expert witness with over a fifteen years of pain medicine experience. With his dual training as both a physician and a lawyer Dr. Carinci is a sought-after expert witness in medico-legal matters on a national stage where he combines distinct acumen and expertise at the intersection of medicine and law. He is double-board certified in both Anesthesiology and in Pain Medicine and maintains an active, full time medical practice. Dr. Carinci is Chief of Pain Management and Director of the Interventional Spine and Pain Treatment Center at the University of Rochester Medical Center and an Associate Professor at the University of Rochester School of Medicine. Prior to his current position, Dr. Carinci was the Director of the Pain Medicine Center at Massachusetts General Hospital and an Instructor at Harvard Medical School. Dr. Carinci trained at Johns Hopkins University School of Medicine, Joh...

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 • genetic testing, novel genetic sequencing, esoteric testing, laboratory testing • HIPAA Privacy, Security, Blockchain special studies MIT • Affordable Care Act, HITECH Act, electronic medical records, meaningful use, patents, and intellectual property in heal Healt...

Life Care Planning, Medical Billing - Bill Reviews, NJ PIP Law, New Jersey Haines Decision, Life Care Planning, Medical Cost Projection Specialist

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 1,000 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 earned the Certified Professional Biller certification through the American Academy of Professional Coder (AAPC). His bill review practice has had significant focus in New Jersey matters, including pre and post Haines decision involving UCR values, as well as NJ PIP Fee Schedule. Jim has extensive clinical experience having cared for patients in various lif...

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 • genetic testing, novel genetic sequencing, esoteric testing, laboratory testing • HIPAA Privacy, Security, Blockchain special studies MIT • Affordable Care Act, HITECH Act, electronic medical records, meaningful use, patents, and intellectual property in heal Healt...

Internal Medicine, Hospitalist - Independent medical examiner, medical bariatrics, medical billing, Diabetes, Hipaa, hospice and palliative care, HMO, life care planning, long term care, medical billing and coding, medical management, obesity, preventive medicine, urgent care

Medical Billing, Medical Coding - Medical Bill Review, Reasonableness of Medical Bills, 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 Billing - Medical Costs, Medical Billing, Chargemaster Analysis, Healthcare Finance

PROFESSIONAL SUMMARY 30 years experience in top level hospital management with a strong financial background WORK EXPERIENCE Regional CFO 9/2016 to 3/2020 NewLight Healthcare Austin, TX • Provide CFO services for rural hospitals • Consult with rural hospitals on financial issues Chief Financial Officer 10/2013 to 9/2016 Connally Memorial Medical Center Floresville, TX • Served as Chief Financial Officer • Worked closely with management team to ensure financial success of the hospital • Oversaw all accounting, charging, billing and coding activities Regional CFO 7/2010 to 7/2013 NewLight Healthcare Austin, TX • Provide CFO services for rural hospitals • Consult with rural hospitals on financial issues Owner 11/2007 to Present Jamie R Jacoby, CPA Menard, TX • Provide business advisement services to small and medium businesses • Prepare tax returns for businesses and individuals • Provide tax planning services Chief Financial Officer 11/2008 to 2/2010 Rural Hospital Management As...

Spine Surgery & Spine Care, Medical Coding - Spine fusion, Spine tumors, Spine trauma, Laminectomy, Discectomy, Total disk replacement, Decompression, Dural tear, Pedicle screws, Independent medical examinations, IME, Causation, Medical coding, Medical billing, Medical necessity, Spinal abscess, Disability evaluation, Workers Comp, MVA

Board Certified in Orthopedic Surgery and Spine Surgery in active clinical practice. Fellowship trained in both spinal reconstructive surgery and musculoskeletal oncology and reconstruction. 20+ years clinical experience in spine surgery. Well-experienced public speaker. Special expertise in spinal care coding. New Mexico State Team Physician. Experienced expert witness, independent medical examiner, and medical necessity peer reviewer. Licensed in New Mexico, Texas and Arizona.

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, Accessibility, Medical Billing, Case Management, Benefit Application

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 • genetic testing, novel genetic sequencing, esoteric testing, laboratory testing • HIPAA Privacy, Security, Blockchain special studies MIT • Affordable Care Act, HITECH Act, electronic medical records, meaningful use, patents, and intellectual property in heal Healt...