Medical Billing Expert Witnesses
What is a medical billing expert witness?
Medical billing expert witness candidates have years of experience in healthcare administration, medical coding, and/or provider compliance with training as a Certified Professional Medical Auditor (CPMA) or Certified Professional Coder. Health insurance billing expert witnesses have extensive HIPAA knowledge specific to insurance billing practices. Physician billing expert witnesses and medical insurance billing expert witnesses may work in tandem, combining their expertise. Medical bill review expert witnesses have an advanced degree and associated with an organization such as the American Academy of Professional Coders (AAPC) or the Healthcare Billing & Management Association (HBMA).
What types of cases require a medical billing expert witness?
Medical billing involves filing claims with health insurance organizations to receive payment for services rendered. Medical coding is an important component of medical billing and involves an analysis of medical provider statements and the assignment of standard codes using a classification system.
Medical billing expert witness case examples
Example cases that Cahn Litigation Services has searched for medical billing expert witnesses for have encompassed:
- Current Procedural Terminology (CPT codes),
- Medicare fraud,
- Medicaid medical bill reimbursement,
- neurology medical records,
- life care plan payers,
- International Classification of Diseases (e.g., ICD-9, ICD-10-CM),
- Certified Life Care Planner (CLCP) qualifications,
- insurance companies reimbursement for medical services,
- medical cost and medical necessity assessment as a result of a personal injury,
- clinical documentation auditing,
- Medicare and Medicaid fee schedule and medical bill reviews,
- HIPAA matters,
- Medicare Set-Aside law,
- electronic health records (EHR) breach,
- false claims act matters (Qui tam),
- independent medical examination (IME) methodology, and
- medical malpractice.
What litigation support work might a medical billing expert witness be expected to perform?
Expert witness services by a subject matter expert in medical billing could include research and authoring expert reports, providing expert opinions, deposition testimony, and trial testimony. In a high-profile case, or litigation involving a significant financial stake, the lead attorney may request a medical billing or medical coding expert with prior expert testimony experience.
Cahn Litigation Services has the experience required to turn a search for a medical billing expert witness around quickly, providing the right balance of expertise and testimony experience. On behalf of a plaintiff or defendant, the firm has an earned reputation for providing experts with the right balance of expertise and testimony experience to support each unique project.
Medical Billing Expert Witness - Representative Bios
Please Note: All Cahn Litigation expert witness searches are customized to attorneys' precise specifications and preferences. Attorneys are encouraged to discuss search parameters with a Cahn search specialist.
The below expert witness bios represent a small fraction of those Medical Billing experts known by Cahn Litigation Services. These bios are provided to give lawyers a sense of the Medical Billing landscape.