Utilization Review Expert Witnesses

Utilization review 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 utilization review. The utilization review expert witness listings on this page are typically from fields/areas of expertise such as: Emergency Medicine, HMO, Hospitalist, Internal Medicine, Life Care Planning, Long Term Care, Medical Management, Physical Medicine & Rehab, and Risk Management.

Geni A Bennetts, MD MA FAAP FACMQ CHCQM CPE

Hospital, Managed Care, Compliance, Safety Expert

Resolve Healthcare Consulting

Napa, California
Medical Management, Risk Management - Medical Quality, Hospital and Medical Management, Hospital Compliance, Medical Compliance, HIPAA, Grievance and Appeals, Managed Care, Joint Commission, CMS, Utilization Review, Patient Safety, Hospital Governance
Dr. Geni Bennetts is an experienced physician executive in healthcare and is a Certified Physician Executive. She has been a hospital subspecialist and Chair of that division. She has chaired hospital care management and managed care compliance. She served as a hospital risk management chair. She is a founder and principal of Resolve Healthcare Consulting. She was Vice Chair, Chair of the Asset/Liability Committee and then Chair of a Bank Board, the latter position held for 5 years. She has been an examiner for the California Department of Managed Health Care and has reviewed over 40 health plans for Quality, Utilization, Grievance and Appeals, and Access and Availability. She has consulted for a number of health plans and held positions for health plans, hospitals and IPAs as consulting interim CMOs, Medical Directors, and Advisors. For the past 14 years Dr. Bennetts has consulted in the following areas of expertise: Patient safety and hospital responsibility and compliance...

Kenneth Botwin, MD CPLCP CLCP

Exalt Life Care Plans

California
Life Care Planning, Physical Medicine & Rehab - Life Care Planning, Medical Cost Projection, Utilization Review, IME, Personal Injury, Auto Accident, Trucking Accident, Pain Management, PMR, Disability, Workers Compensation, Trauma, TBI, Premise Liability, Plaintiff, Defense, Medical Summary, Demands, Medical Expert, Brain Injury
With a successful 30-year career as a partner at one of the most preferred spine and pain practices in Florida, Dr. Kenneth Botwin has expanded his expertise in medical expert testimony. Dr. Botwin is board-certified in Pain Management & Rehabilitation, Electrodiagnostic Medicine, and Medical Specialties in Pain Management. He is a Certified Life Care Planner and Certified Physician Life Care Planner providing the most elite standard of Future Medical Care and Costing. Dr. Botwin is a published author with over 30 publications relating to his field. He currently serves on the Editorial Advisory Board for the Pain Physician Journal. Dr. Botwin’s experience and exponential knowledge in permanent injury, regenerative medicine, worker’s compensation, and minimally invasive procedures make him the most appropriate expert in personal injury, workers compensation, and premise liability cases. Dr. Botwin provides expert witness testimony for both plaintiff and defense following the ...

Eric T. Ory, MD

Emergency Medicine Physician - Expert Witness

California
Emergency Medicine - Emergency, Utilization Review, Wound Care, Trauma, Cardiology Emergencies, Procedural Sedation, Stroke, Orthopedic Emergencies, Toxicology Emergencies, Respiratory Emergencies, Neurologic Emergencies, Gastrointestinal Emergencies, Standard of Care, Board Certified, Sepsis, Airway Management
With over 25 years of clinical practice in emergency medicine and treating over 100,000 patients, I bring a wealth of experience to improve patient outcomes. Certified in ACLS, PALS, and BLS, and Board Certified by the American Board of Emergency Medicine, my extensive expertise includes managing all emergency medical conditions and trauma across diverse demographics. Having worked in high volume, high acuity settings and critical access facilities, I understand the challenges faced by emergency physicians. My strength lies in face-to-face patient interaction and collaborating with various medical specialties. After years of chart review focusing on preliminary evaluations, I aim to return to assisting clients throughout the entire litigation process. My goal is to leverage my clinical experience to provide comprehensive support from start to finish.

Kenneth Botwin, MD CPLCP CLCP

Exalt Life Care Plans

Connecticut
Life Care Planning, Physical Medicine & Rehab - Life Care Planning, Medical Cost Projection, Utilization Review, IME, Personal Injury, Auto Accident, Trucking Accident, Pain Management, PMR, Disability, Workers Compensation, Trauma, TBI, Premise Liability, Plaintiff, Defense, Medical Summary, Demands, Medical Expert, Brain Injury
With a successful 30-year career as a partner at one of the most preferred spine and pain practices in Florida, Dr. Kenneth Botwin has expanded his expertise in medical expert testimony. Dr. Botwin is board-certified in Pain Management & Rehabilitation, Electrodiagnostic Medicine, and Medical Specialties in Pain Management. He is a Certified Life Care Planner and Certified Physician Life Care Planner providing the most elite standard of Future Medical Care and Costing. Dr. Botwin is a published author with over 30 publications relating to his field. He currently serves on the Editorial Advisory Board for the Pain Physician Journal. Dr. Botwin’s experience and exponential knowledge in permanent injury, regenerative medicine, worker’s compensation, and minimally invasive procedures make him the most appropriate expert in personal injury, workers compensation, and premise liability cases. Dr. Botwin provides expert witness testimony for both plaintiff and defense following the ...

Kenneth Botwin, MD CPLCP CLCP

Exalt Life Care Plans

Port Richey, Florida
Life Care Planning, Physical Medicine & Rehab - Life Care Planning, Medical Cost Projection, Utilization Review, IME, Personal Injury, Auto Accident, Trucking Accident, Pain Management, PMR, Disability, Workers Compensation, Trauma, TBI, Premise Liability, Plaintiff, Defense, Medical Summary, Demands, Medical Expert, Brain Injury
With a successful 30-year career as a partner at one of the most preferred spine and pain practices in Florida, Dr. Kenneth Botwin has expanded his expertise in medical expert testimony. Dr. Botwin is board-certified in Pain Management & Rehabilitation, Electrodiagnostic Medicine, and Medical Specialties in Pain Management. He is a Certified Life Care Planner and Certified Physician Life Care Planner providing the most elite standard of Future Medical Care and Costing. Dr. Botwin is a published author with over 30 publications relating to his field. He currently serves on the Editorial Advisory Board for the Pain Physician Journal. Dr. Botwin’s experience and exponential knowledge in permanent injury, regenerative medicine, worker’s compensation, and minimally invasive procedures make him the most appropriate expert in personal injury, workers compensation, and premise liability cases. Dr. Botwin provides expert witness testimony for both plaintiff and defense following the ...

Luis Ycaza, DO LCP-C

Exalt Life Care Plans

Port Richey, Florida
Life Care Planning, Internal Medicine - Life Care Planning, Medical Cost Projection, Utilization Review, IME, Personal Injury, Auto Accident, Trucking Accident, Nursing Home, Medical Malpractice, Pain Management, Disability, Workers Compensation, Premise Liability, TBI, Brain Injury, Trauma, Medical Summary, Demands
Dr. Luis Ycaza has over 25 years of experience specializing in post-acute and rehabilitation with 16 years in the personal injury and premise liability space. Dr. Ycaza provides expert witness testimony for both plaintiff and defense following the most defensible methodology in future care and costing. Dr. Ycaza has successfully opined on Causation, Permanency, Future Medical Treatment, and Future Medical Costs. Services offered include Life Care Plans, Medical Cost Projections, Independent Medical Exams, Utilization Review, Rebuttal Reports, and Medical Summarization. For free consultation and review of any case email us at [email protected] or call us at 727-287-2772. Simple Flat Rate Pricing. Services Nationally. English and Spanish Speaking.

John H Gong, MD

LG Healthcare LLC

Kildeer, Illinois
Internal Medicine, Hospitalist - Outpatient Internal Medicine, Hospital Medicine, Nursing Home Medicine, Nursing Home Medical Director, Hospice Medical Director, Utilization Review, Geriatrics, Family Medicine Residency, Medical Education
I have 30 years of experience as a practicing internist and hospitalist. I have 10 years of experience in academic medicine when I was clinical faculty teaching family practice residency physicians in both outpatient internal medicine and inpatient hospital medicine. I won the Gold Apple Teaching award almost every year I was clinical faculty even though I'm an internist teaching in a family practice residency program. I'm an expert in the clinical scope of expertise of outpatient internal medicine, family medicine, and hospital medicine. I also have extensive experience in nursing home medicine and hospice care as I have been medical director for 4 skilled nursing facilities and 2 hospice agencies. I also have experience with hospital utilization review as a medical advisor for Centegra Health Systems. I left my teaching position over 10 years ago to establish a hospitalist programs in 2 different hospital settings. I am now in private practice with both an outpatient practice...

Vera Dvorak, MD

TD&P Consulting Inc.

Silver Spring, Maryland
Medical Management, Long Term Care - Home Healthcare, Managed Care, Transitional Care Management, Medical Necessity Determination, Long-Term Care Planning, Evidence-Based Care Guidelines Expert, Patient-Centered Care Expert, Geriatric Services, Utilization Review, Medical Valuation, Infectious Disease
Vera Dvorak, MD, has broad and extensive experience in a continuum of care, with over 40 years working in diverse healthcare settings including home health services, palliative care, and hospice. She has also served as medical director in all of these areas. Dr. Dvorak has been a practicing physician, a managed care executive, a strategic member of corporate leadership, and vice president and medical director of hospital-based care coordination. She has been in charge of the appeals department in various managed care organizations; and is the founder of transitional care management for one of the largest healthcare systems in Northern Virginia. Dr. Dvorak’s focus has been on medical necessity determination, appropriate discharge disposition with defined short and long-term care needs. She has been a proponent of consistently applying evidence-based care guidelines to support clinical decision-making on a case-by-case basis and across the continuum of care to maximize the potenti...

Kenneth Botwin, MD CPLCP CLCP

Exalt Life Care Plans

Massachusetts
Life Care Planning, Physical Medicine & Rehab - Life Care Planning, Medical Cost Projection, Utilization Review, IME, Personal Injury, Auto Accident, Trucking Accident, Pain Management, PMR, Disability, Workers Compensation, Trauma, TBI, Premise Liability, Plaintiff, Defense, Medical Summary, Demands, Medical Expert, Brain Injury
With a successful 30-year career as a partner at one of the most preferred spine and pain practices in Florida, Dr. Kenneth Botwin has expanded his expertise in medical expert testimony. Dr. Botwin is board-certified in Pain Management & Rehabilitation, Electrodiagnostic Medicine, and Medical Specialties in Pain Management. He is a Certified Life Care Planner and Certified Physician Life Care Planner providing the most elite standard of Future Medical Care and Costing. Dr. Botwin is a published author with over 30 publications relating to his field. He currently serves on the Editorial Advisory Board for the Pain Physician Journal. Dr. Botwin’s experience and exponential knowledge in permanent injury, regenerative medicine, worker’s compensation, and minimally invasive procedures make him the most appropriate expert in personal injury, workers compensation, and premise liability cases. Dr. Botwin provides expert witness testimony for both plaintiff and defense following the ...

Eric T. Ory, MD

Emergency Medicine Physician - Expert Witness

Eugene, Oregon
Emergency Medicine - Emergency, Utilization Review, Wound Care, Trauma, Cardiology Emergencies, Procedural Sedation, Stroke, Orthopedic Emergencies, Toxicology Emergencies, Respiratory Emergencies, Neurologic Emergencies, Gastrointestinal Emergencies, Standard of Care, Board Certified, Sepsis, Airway Management
With over 25 years of clinical practice in emergency medicine and treating over 100,000 patients, I bring a wealth of experience to improve patient outcomes. Certified in ACLS, PALS, and BLS, and Board Certified by the American Board of Emergency Medicine, my extensive expertise includes managing all emergency medical conditions and trauma across diverse demographics. Having worked in high volume, high acuity settings and critical access facilities, I understand the challenges faced by emergency physicians. My strength lies in face-to-face patient interaction and collaborating with various medical specialties. After years of chart review focusing on preliminary evaluations, I aim to return to assisting clients throughout the entire litigation process. My goal is to leverage my clinical experience to provide comprehensive support from start to finish.

Frank L Brown, Jr, MD, MBA, FACP

HMO, Managed Care, and Credentialing Expert

AMERICLIN FORENSIC CONSULTING

Bluffton, South Carolina
HMO, Medical Management - Workplace Discrimination, HMO & Managed Care, Appeals & Grievances, Hospital & Provider Credentialing, Utilization/Medical Necessity, Healthcare Fraud/Abuse, Utilization Review, Physician Defamation, Quality & Patient Safety, Physician Sanctions, Medical Management, Disease Management, Privileging
AMERICLIN® FORENSIC CONSULTING (AFC) is a physician-led collaborative of skilled consulting clinical expert witnesses. There are currently over 50 clinicians in the AF network who seek to provide case-winning strategies for lawyers nationwide. Upon contacting us, we provide a no-charge consultation to discuss the case. Our full suite of services includes: • Free initial phone consultations with expert clinicians • Flat fee initial case reviews • Dynamic clinical case theory analysis and development Phone: (843) 949-0927 Email: [email protected] AREAS OF EXPERTISE: Accountable Care Organizations Appeals & Grievances Case Management Correctional Healthcare Disease Management Disruptive Physicians Elder Abuse Emergency Medicine Geriatrics Healthcare Fraud/Abuse HMO & Managed Care Hospital & Provider Credentialing Internal Medicine Medical Insurance Medical Necessity Patient Grievances and Appeals Patient Safety Pharmacy Pharmacology Physician Burnout Physician Credentiali...