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Description
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 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, anesthesia, Nephrology, MIPS, MACRA, Computer Assisted Coding, Physician Fee Schedule, Medicare Administrative Contractors, Medicaid expansion, Qualified Health plans - Labor Law, uninsured patient discounts, California Law confidential information, Benefits Administration, Fraud under Qui Tam False Claims Act. Eligibility, coverage determinations; physical therapy, HL7, ICD-10, computer-assisted coding, Knox-Keene Act, Stark Law, Sunshine Act, Insurance Bad Faith. • Medicare Secondary Payor Act, Physician-Hospital Contracts, Valuation, Health IT businesses, FQHC, ASC, ESRD, EMTALA. Claims processing, Independent Diagnostic Testing Facility (IDTF) coverage determinations, lien, balance billing subrogation, clinical documentation, billing, audits, fraud, waste abuse (E&M, orthopedics, cardiology, vascular, MRI, PET, pathology, ESRD tests, esoteric test, nephrology, diabetes). Payor contracting, arbitration, third party liability. Day global period surgical period • ERISA self-insured plan regulations including cost sharing, full and fair review.
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