Medical Billing Expert Witnesses in Georgia

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

Summary of Qualifications National healthcare expert witness with extensive federal and state court experience. Published author, speaker, and peer-reviewed authority featured in Westlaw federal court rulings. Federal Precedent: Expert opinions considered by the U.S. Court of Appeals, resulting in a Vacated and Remanded ruling. DOJ Retentions: Retained twice by the Department of Justice, contributing to a $155 million settlement. Advanced Credentials: Specialized studies in HIPAA Privacy, Security, and Blockchain at MIT. Areas of Expertise Medical Billing, Coding & Reimbursement: Usual, Customary, and Reasonable (UCR) charges in personal injury and medical malpractice; Affordable Care Act (ACA) Life Care Plan rebuttals (future cost of care); trauma, workers' compensation, liens, balance billing, subrogation, and uninsured patient discounts (including California law/Knox-Keene Act). Healthcare IT & Forensics: Technical Expert in healthcare IT patents and intellectual property; Elec...

Medical Billing, Fraud - 60-Day Rule, Hospice, Corrective Action Plan, Cost Report, Coding, Statistical Sampling, Overpayment, Skilled Nursing, Home Health, FCA, Medicare, Hospital, Physician, False Claim, Physician Contract, Compliance Training, Anti-Kickback, Laboratory Billing, Medical Necessity, Clinical Documentation

Mr. Loria has 53 years of healthcare (HC) regulatory compliance, M&A, Medicare reimbursement and appeals, hospital pricing, managed care contracting and litigation support. Extensive expert witness experience before the Provider Reimbursement Review Board, ALJ proceedings, civil and criminal litigation, and mediation and arbitration proceedings. Mr. Loria has represented hospitals, nursing facilities, home health, hospice, reference laboratory, physician groups, and other providers in Medicare appeals and controversies. During his career he has managed more than 2,000 Medicare disputes and other investigations. He was a Partner in the SW Regional HC practice of PwC. Prior to joining PwC as a Partner, he was the National Director of the Regulatory practice at EY for 10 years. He founded Loria Associates in 2002 and serves as CEO and Managing Director. He has consistently served HC clients on a nation-wide basis and delivered excellent results based on his unique qualifications a...

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

Atlanta, Georgia

Life Care Planning, Medical Billing - Life Care Plan, Life Care Planner, Nurse Expert, Nurse, LCP, TBI, Brain Injury, Amputation, Cerebral Palsy, Birth Injuries, Life Care Plans, Damage Assessments, Medical Bill Reviews, Medical Bill Review, Life Care Plan Rebuttal, Motor Vehicle Accidents, Medical Malpractice, Catastrophic Claims, Accidents, Injuries

Misty Coffman, RN, MSCC, CNLCP is a highly experienced Nurse Life Care Planning expert witness with nearly four decades of nursing practice and extensive deposition and trial experience. She brings exceptional credibility, leadership, and real-world clinical depth to complex personal injury, medical malpractice, and catastrophic injury cases. She has been a Registered Nurse for 37 years and served as President of the American Association of Nurse Life Care Planners (AAANLCP) in 2024, following her tenure as an Executive Board Member from 2022–2024. Her national leadership role reflects peer-recognized expertise and a deep command of life care planning standards and methodology. Her clinical and administrative background spans a broad range of healthcare settings, including orthopedic nursing, medical-surgical nursing, occupational health, long-term and skilled nursing care, medical billing, and healthcare compliance. She has held senior leadership roles such as Director of Nursing...