Medical Coding Expert Witnesses

Birmingham, Alabama

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

Arizona

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.

Seal Beach, California

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...

California

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...

San Ramon, California

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.

Somers, Connecticut

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, for negotiating discounts on medical bills.

Orlando, Florida

Medical Coding, Medical Billing - CPC, CPMA, COC, CCS, medical coding, medical billing, medical auditing, Qui tam, AAPC, CIA, IRO, Medicare, Inspector General

Ms. Diamond is an experienced coding, billing, and auditing professional who is available for consultation in medical practice auditing, billing, coding, compliance, litigation, reimbursement, and revenue cycle issues when requested by medical providers, their management, or their legal counsel. She is a Certified Professional Coder (CPC) and Certified Outpatient Coder (COC) by the American Association of Professional Coders (AAPC), with her initial certifications over 30 years ago. She has served as a member of the AAPC National Advisory Board, has been a Fellow of the AAPC, and has served as President of the Greater Orlando Chapter of AAPC. She is a Certified Professional Medical Auditor (CPMA) by the AAPC. For 18 years, she led billing and coding for a university multi-specialty medical practice of over 400 physicians. She has 20 years of experience as a medical auditor with a company that provided medical auditing services for medical practices, hospitals, and commercial me...

Melbourne, Florida

Medical Coding, Ophthalmology - Surgeon, Coder, Auditor, Fair and Reasonable Value, Medical Coding, Physician Coding, Ophthalmology Coding, Optometry Coding, Reimbursement, Eye Care, Coding, Medicare, Healthcare Fraud, Audits, False Claims Act, National Correct Coding Initiative, Bundling

ABOUT: Highly experienced expert witness with 100+ cases in medical coding, reimbursement, and compliance across the entire medical spectrum, providing services for both plaintiff and defense. Board-certified practicing physician and surgeon, Certified Coding Specialist (Physician-based), and Certified Professional Medical Auditor. Awarded graduate of Cornell University’s College of Engineering (B.S.) and the University of Michigan Medical School (M.D.), with postgraduate specialty training at Johns Hopkins Hospital and the University of California, San Francisco. Master-level graduate (M.B.A.) of the University of Central Florida, College of Business Administration. Chairman of the Ophthalmology Section at Holmes Regional Medical Center in Melbourne, Florida. Assistant professor at the University of Central Florida, College of Medicine. Extensive committee involvement, including American Medical Association’s CPT Advisory Committee and the Florida Medicare Carrier Advisory Com...

Reno, Nevada

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...

Newbury, New Hampshire

Medical Billing, Medical Coding - ALL STATES, Medical Billing, Coding, Usual and customary, reasonable and customary, DRG, CPT, ICD-10, ICD-9, medical necessity, fees, fee schedule, billing

Mark L Friedman MD FACEP FACP is currently Chief Medical Officer Emeritus of First Stop Health. He is an emergency physician emeritus at St Vincent’s Hospital in Bridgeport, CT. He was formerly Associate Professor of Emergency Medicine at the Frank Netter School of Medicine, Chief of Emergency Medicine at St Elizabeth's Hospital of Boston, Assistant Professor of Medicine at Tufts University School of Medicine, Assistant Clinical Professor of Emergency Medicine at the University of Illinois, and Adjunct Professor of Public Health at Benedictine University. Dr. Friedman is an expert in DRG claims analysis and medical cost containment. He has helped design programs to prevent medical errors as well as malpractice litigation. He has served as an advisor to government on medical billing fraud and abuse and developed two companies that perform audits for the Medicare RAC. Dr. Friedman is a frequent speaker and the author of numerous articles and books on medically related topics. Dr Fr...

Las Cruces, New Mexico

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.

Oregon

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.

Athens, Tennessee

Chiropractic, Medical Coding - Insurance, Fraud, Billing, Documentation, Malpractice

Diplomate of the American Board of Quality Assurance and Utilization Review Physicians, Certified Healthcare Quality Manager, Certified Professional Coder, Former in-house claims and policy consultant for a nationwide health insurance payer, Current subject matter expert for two managed care entities, Extensive experience in review of personal injury, workers compensation, and maplractice cases, Experienced expert witness for malpractice, insurance and fraud cases

Fort Worth, Texas

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).

DALLAS, Texas

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

Texas

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.

Adell, Wisconsin

Chiropractic, Medical Coding - Sports Medicine, Medical Malpractice, Chiropractic malpractice, motor vehicle accidents, motor vehicle collisions, independent medical examinations, legal medicine, physical therapy, coding, standard of care, scope of practice, insurance fraud, benefits, Taft- Hartley, personal injury,

Dr. Boll has extensive medicolegal experience and has been in practice since 1992. He has been retained nationwide for various cases. Dr. Boll assists numerous entities (law enforcement, law firms, insurance carriers, TPAs) as an Expert Witness, Consulting Witness, CPT and diagnostic coding issues, File Review, and Independent Medical Examinations, along with internal educational programs. He is a Certified Professional Coder (CPC) from AAPC and a Performance Enhancement Specialist (PES) from NASM. Dr. Boll has active licenses in both Wisconsin and Michigan. He continues to practice within his athletic training and conditioning facility, serving two school districts and consulting with professional racing sanctioning bodies regarding race weekend injury concerns. Dr. Boll was a former Chiropractic Services Director for an insurance company, where he assisted in writing guidelines, sitting on appeals panels, and establishing internal review and claims processing measures. He is a cu...