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Medical Coding Expert Witnesses

Medical coding 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 medical coding. The medical coding expert witness listings on this page are typically from fields/areas of expertise such as: Internal Medicine, Legal Nurse Consulting, Life Care Planning, Long Term Care, Medical Billing, Medical Coding, Nurse, Ophthalmology, Orthopedic Surgery, Spine Surgery & Spine Care, and Sports Medicine.

Michael F. Arrigo

Health Informatics
Electronic Health Records
ICD-10 Healthcare Coding

Paul Saiz, MD

Spine Surgeon
Experienced Expert
Spine Coding

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Paul Saiz, MD, FAAOS, CIME

Spine surgery and coding expert

3 Crosses Orthopedic Spine

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 and medical necessity. New Mexico State Team Physician. Experienced expert witness, certified independent medical examiner, and medical necessity peer reviewer. Licensed in New Mexico, Texas and Arizona. Co-vice chair North American Spine Society Coding Committee.

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Michele Elmore, MSN, RN, SANE-A

Pediatrics - Forensic Nurse - SANE-A

Justice Forensics

Fort Smith, Arkansas

Legal Nurse Consulting, Nurse - Pediatrics, Medical chart review, Acute hospital care, Long term care, Adolescent, Sexual Assault, Analysis, Neonatal, Medical billing, Report writing, Abuse, Review, Infant, Medical coding, Wrongful death, Expert witness, Intensive care, Adult

CERTIFIED * EXPERIENCED * SPECIALIZED * INTEGRATED * COMPASSIONATE CERTIFIED: Board Certified MSN, RN, SANE-A EXPERIENCED: Justice Forensics offers over 33 years in professional nursing practice, 10 years of experience on the nursing faculty at the University of Arkansas. Current Director at Large for the Arkansas Forensic Nursing Association, 10 years Clinical and Didactic pediatric Instructor at the Fort Smith campus, and experience in: acute care hospitals, pediatrics, neonatal intensive care, Infant and pediatric ICU, special care nursery, OB/post-partum, and long-term pediatric care. Our team also has over 20 years of medical billing and coding. SPECIALIZED: Pediatric and neonatal care. Forensic Nurse Examiner, SANE-A, with expertise in sexual abuse and assault, anogenital findings, injury interpretation for sexual contact and sexual assault, forensic evidence collection, chain of custody compliance and analysis, forensic photography, and medical records. INTEGRATED: O...

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Roberto Contreras II, MD, CLCP

California Life Care Planning Association

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...

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Paul D Wagner, MD, FACP

Board Certified Internist, Medical Director, CMO

Paul D. Wagner MD Inc.

San Diego, California

Internal Medicine, Long Term Care - Hypertension management, Failure to diagnose, Diabetes management, Cognitive impairment/dementia management, Preventive screening management, Hyperlipidemia management, Medical coding, eClinicalWorks Subject Matter Expert, Certified Medical Director, Medical billing, Primary Care

Board certified Internist for 30 years. Founder of San Diego Medical Group. eClinicalWorks subject matter expert for all aspects of primary care, documentation, billing and coding. Over 20 years of experience as Chief Medical Officer and Certified Medical Director at a Veterans Home of California overseeing the delivery of healthcare services for ambulatory and long term care resident veterans. Many years as a medical expert witness including records review, depositions, arbitration and court testimony.

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Thomas Peatman, MD

Orthopedic Surgeon and Expert Witness

California

Orthopedic Surgery, Sports Medicine - Hip, Knee, Shoulder, Trauma, Spine Surgery & Spine Care, Orthopedics Non Surgical, Independent Medical Examinations, Causation, Disability evaluation, Impairment Evaluation, Medical Coding, Medical billing, Workers’ Compensation, Motor Vehicle Accident, Patents, MVA

Board-Certified orthopedic surgeon in clinical practice. Additional sub-specialty Certification in Sports Medicine. 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 15+ 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. My reports provide compelling. I have given testimony in 12 trials.

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Marsha S Diamond, CPC, COC, CCS, CPMA

Medical Auditing, Billing, and Coding Expert

Orlando, Florida

Medical Billing, Medical Coding - CPC, CPMA, COC, CCS, medical coding, medical billing, medical auditing, Qui tam, AAPC, CIA, IRO, Medicare, Inspector General, Medical, UCR, Usual Customary and Reasonable, Electronic Medical Records, EMR, Compliance

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...

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L. Neal Freeman, MD, MBA, CCS-P, CPMA

Physician/Surgeon + Medical Coding/Auditing Expert

Coding and Physician Reimbursement Analysts, Inc.

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...

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Adam P Beck

Ophthalmology and Vitreoretinal Surgery Expert

Adam P Beck, M.D., Esq.

Andover, Massachusetts

Ophthalmology, Medical Billing - Ophthalmology Expert Witness, Fraud & Abuse, Retina Surgery, Retinal Detachment, Cataract Surgery, Glaucoma, Macular Degeneration, Uveitis, Oculoplastics, Optometry, Ophthalmology Standard of Care, Eye Surgery, LASIK, Vision Loss, Medical Billing, Medical Coding, Insurance Billing Disputes, Medical Malpractice, Legal Malpractice

Adam P. Beck, M.D., Esq. is a board-certified ophthalmologist and attorney with extensive experience in clinical ophthalmology, vitreoretinal disease, medical billing, and medical-legal analysis. Dr. Beck is the President of New England Eye and Facial Specialists and has been in private practice since 2005, providing comprehensive ophthalmology care with particular expertise in vitreoretinal disease and retinal surgery. Dr. Beck completed a vitreoretinal surgery fellowship at Massachusetts Eye and Ear Infirmary and previously served as a Clinical Instructor in Ophthalmology at Harvard Medical School, where he supervised residents and fellows in the diagnosis and management of complex ophthalmic disease. In addition to his medical training, Dr. Beck earned a Juris Doctor, magna cum laude, from the Massachusetts School of Law and is admitted to the Massachusetts Bar and the United States District Court. This dual background provides a unique perspective on issues involving stand...

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Paul Saiz, MD, FAAOS, CIME

Spine surgery and coding expert

3 Crosses Orthopedic Spine

Las Cruces, New Mexico

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Thomas Peatman, MD

Orthopedic Surgeon and Expert Witness

Bend, Oregon

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Marisa Yermakova

Expert Medical Billing - Coding & Reasonableness

Medical Equation

Austin, Texas

Medical Billing - Revenue Cycle Management, Chargemaster Review, Collections Analysis, Medical Coding Review, Financial Analysis, Coding and Billing Operations, Budgeting, Insurance Billing, Phantom charges, Unbundling Charges, Claims Appeals, Payment Reconciliation

With more than 10 years of experience in healthcare reimbursement and revenue cycle analysis, I offer a specialized focus on benefit verification, claims appeals, payment reconciliation and trend analysis. My background includes in-depth research of payor policy stipulations, medical coding accuracy, and resolving discrepancies through direct communication with high-level insurance representatives. I have led special projects to secure mass payments owed to providers, launched and optimized a practice management system for a multi-provider chiropractic group, and successfully advocated for countless beneficiaries denied medically necessary procedures. I am well-versed in state-specific billing laws and guidelines nationwide and bring a detail-oriented, compliance-driven approach to every case. Available for depositions and trial testimony and willing to travel as needed. For a full CV or testimony list, please reach out directly.

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Bernice Zander

Medical Billing Expert Witness

Abacus Analytics

Austin, Texas

Medical Coding, Medical Billing - UCR, Usual Customary Reasonable, Medical Billing Expert Witness, Medical Coding Expert Witness, Billing Expert Witness, Medical Coding Expert, Medical Billing Expert, AMA

BS, RHIT, CCS

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Megan Smith, DO, MBA

Medical Qui Tam False Claims Expert Witness

MAS Medical Consulting, LLC

Aledo, Texas

Medical Billing, Medical Coding - Qui Tam, Health Insurance Fraud, Medical Necessity, Medicare Fraud, Medicare LCDs, Medicare, Commercial Insurance, Medicare NCDs, Medical Coding, Medicare Billing, Upcoding, Health Insurance Coding, Medicare Abuse, Commercial Insurance Fraud, Medical Policy

Dr. Smith is board certified in internal medicine with experience as a medical director in determining the medical necessity of procedures, post-acute care, admissions and billing & coding questions. Additionally, she has experience in serving as a consultant for pharmaceutical marketing research questions. She is licensed by the State of Texas Medical Board.