Medical Billing Expert Witnesses
Medical billing expert witness candidates typically have years of experience in healthcare administration, medical coding, medical record review, medical care, healthcare provider compliance, and/or are a Certified Professional Medical Auditor (CPMA) or Certified Professional Coder (CPC). Oftentimes medical billing experts have a higher education degree (i.e., MBA or PhD). The chosen expert could be associated with a health information industry organization such as the American Academy of Professional Coders (AAPC), the American Health Information Management Association (AHIMA), the Healthcare Billing & Management Association (HBMA), or the Medical Association of Billers (MAB). 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.
What are medical billing and medical coding?
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.
Example litigation support matters requiring an expert in medical billing include medical malpractice cases, personal injury, healthcare fraud, and health insurance fraud. Expert witness services by a subject matter expert in medical billing could include expert report preparation, expert opinion, deposition testimony, and trial testimony. 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.
Cahn Litigation Services has the experience required to turn a search for a medical billing expert witness around quickly. 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.