Clinical Documentation Expert Witnesses
Clinical documentation expert witnesses and consultants listed here may be able to form expert opinions, draft expert witness reports, provide expert witness testimony at deposition and/or trial as or serve as consulting (non-testifying) experts on clinical documentation. The clinical documentation expert witness listings on this page are typically from fields/areas of expertise such as: Emergency Medicine, Health Informatics, HIPAA, Hospitalist, Medical Billing, Medical Coding, Neurology, Nurse, and Nursing Homes.
Joe Carnes
Medical Billing Expert Witness
Medsurity Experts
Birmingham, Alabama
Medical Billing, Medical Coding
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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
Mark Baker, MD, FACEP, FAMIA
Kailua, Hawaii
Emergency Medicine, Health Informatics
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Emergency Medicine, Health Informatics, Clinical Informatics, Medical Records, Electronic Health Records, EHR, EMR, Alert Fatigue, Clinical Documentation, Quality Improvement
Dr. Baker is board certified in both Emergency Medicine and Clinical Informatics. Clinical practice includes more than 30 years of emergency medicine. He was in the first group of physicians to become board certified in clinical informatics. He is on faculty at the University of Hawaii John A. Burns School of Medicine and teaches a graduate level course in Health Informatics. He Is the Medical Informatics Director at his primary hospital and a past Chief-of-Staff. He coordinates the emergency department informatics committee for a four-hospital system and assisted with the Epic implementation for all four hospitals. He is licensed in Hawaii and California. He trained at Harbor - UCLA Medical Center and worked in California prior to moving to Hawaii. He has recent informatics training through Oregon Health and Science University.
Kim A Reich, MBA, MJ, PBCI, RHIA, CPHIMS, CEDS, CPHQ, FAHIMA
KBS Consulting & Expert Witness Services
Lake Forest, Illinois
Health Informatics, HIPAA
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Electronic Health Information Systems, (CPHIMS) Medical Records, Healthcare EDiscovery, (CEDS) Information Governance, Electronic Health Records, Health Insurance, Healthcare Compliance, Clinical Documentation, CEDS, RHIA, Quality Improvement (CPHQ)
Kimberly is a credentialed (MBA, MJ, PBCI, RHIA, CPHIMS, CEDS CPHQ, FAHIMA) healthcare ediscovery, HIPAA, information governance, quality management, and compliance professional with over 30 years of experience in a variety of healthcare settings. She is a national speaker and author on the topics of health information operations, including HIPAA, e-discovery, information governance and healthcare compliance. Kim has been an active member of the Health Level Seven (HL-7) Working Group responsible for review and development of the Records Management and Evidentiary Support (RM-ES) profile for the design and development of the functional profile for Electronic Health Record (EHR) systems since 2006. She has also been an active member and contributor in AHIMA task forces and working groups related to electronic discovery. Kim holds a Master’s of Business (MBA) from the Lake Forest Graduate School of Management, a Master’s of Jurisprudence (MJ) in Health Law and Policy from the Loyola S...
Robert A. Craven, MD, SFHM, FACP, CHCQM-PHYADV
Craven Medical Consulting, LLC
North Carolina
Nursing Homes, Hospitalist
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Nursing home, hospital medicine, causation, standard of care, perioperative medicine, wrongful death, critical care, wound care, pressure ulcers, medical insurance denials, clinical documentation, insurance denial appeals
I have over 7 years of case review experience including post-acute care (i.e., skilled nursing home, acute rehab, etc.), internal medicine, hospital medicine, medical malpractice, disability appeals, and state medical board standard of care reviews. I have experience with disability hearings, depositions, interrogatory reports, and writing medical summaries. I have a very flexible schedule and have most reviews completed in under one month. I have also been used as an expert witness in overturning insurance denials.
I am board certified in internal medicine by the American Board of Internal Medicine and healthcare quality management with physician advisor subspecialty by the American Board of Quality Assurance and Utilization Review Physicians. I am a Fellow of the American College of Physicians (FACP) and a Senior Fellow of Hospital Medicine (SFHM). I have over 13 years of clinical experience as a hospitalist physician in a variety of hospital environments. I am also frequently u...
Cynthia Cross, MSN, RN, CCRN, CNSc
Nursing Practice Expert- All Inpatient Specialties
Franklinton, North Carolina
Nurse, Neurology
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Critical Care, Stroke, Brain Injury, Spine Surgery, Neurologic Surgery, Medical-Surgical Conditions, Pharmacology, Patient Safety, Clinical Documentation, Care Planning, Scope of Nursing Practice
Neuroscience Clinical Nurse Specialist with certification in Adult Critical Care practicing in a large health care system. Current practice includes providing direct patient care and being a neurologic expert for nursing staff and liaison for the medical team members. Ensure evidence based practice for neuroscience population and nursing practice within scope of licensure. Investigate patient safety risk with implementation of quality improvement as needed.
Extensive experience with Stroke, Spine Surgery, Brain Surgery, Critical Care, Medical-Surgical & Ambulatory Care populations. Clinical focus and experience incorporating and ensuring standards of care, evidence based practice, scope of practice, quality improvement, electronic medical record documentation, patient safety, policy and guideline implementation, and expectations of interprofessional clinical practice.
Experience as legal nursing expert for over 6 years.
Robert A. Craven, MD, SFHM, FACP, CHCQM-PHYADV
Craven Medical Consulting, LLC
Murrells Inlet, South Carolina
Nursing Homes, Hospitalist
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Nursing home, hospital medicine, causation, standard of care, perioperative medicine, wrongful death, critical care, wound care, pressure ulcers, medical insurance denials, clinical documentation, insurance denial appeals
I have over 7 years of case review experience including post-acute care (i.e., skilled nursing home, acute rehab, etc.), internal medicine, hospital medicine, medical malpractice, disability appeals, and state medical board standard of care reviews. I have experience with disability hearings, depositions, interrogatory reports, and writing medical summaries. I have a very flexible schedule and have most reviews completed in under one month. I have also been used as an expert witness in overturning insurance denials.
I am board certified in internal medicine by the American Board of Internal Medicine and healthcare quality management with physician advisor subspecialty by the American Board of Quality Assurance and Utilization Review Physicians. I am a Fellow of the American College of Physicians (FACP) and a Senior Fellow of Hospital Medicine (SFHM). I have over 13 years of clinical experience as a hospitalist physician in a variety of hospital environments. I am also frequently u...