Medical Billing Expert Witnesses in Connecticut

Medical Billing, HIPAA - Medical billing expert, Patents trade secrets, electronic medical records, Medicare fraud, medical billing fraud, qui tam false claims act, Meaningful Use Electronic Health Records, HITECH Act, Affordable Care Act, Medicare Advantage, Medicaid, insurance, EMTALA, HIPAA, rebut life care, Usual Customary Reasonable (UCR), damages

Writer, speaker, published peer-reviewed works as an expert in the field recent Federal court rulings as a qualified expert published in Westlaw • US COURT OF APPEALS considered expert opinions, VACATED AND REMANDED • Two DOJ retentions, $155 million settlement • Healthcare IT patents intellectual property Technical Expert, Medicare Damages Expert • Medical coding medical billing, claims, usual customary and reasonable charges in personal injury and medical malpractice cases, Lifecare plan rebuttal under ACA on the future cost of care, trauma • Electronic medical record forensics / electronic health record forensics, E.H.R, practice management IT, medical, prescription charges, workman's compensation, insurance fraud • genetic testing, novel genetic sequencing, esoteric testing, laboratory testing • HIPAA Privacy, Security, Blockchain special studies MIT • Affordable Care Act, HITECH Act, electronic medical records, meaningful use, patents, and intellectual property in heal Healt...

Medical Billing, Fraud - 60-Day Rule, Hospice, Corrective Action Plan, Cost Report, Coding, Statistical Sampling, Overpayment, Skilled Nursing, Home Health, FCA, Medicare, Hospital, Physician, False Claim, Physician Contract, Compliance Training, Anti-Kickback, Laboratory Billing, Medical Necessity, Clinical Documentation

Mr. Loria has 53 years of healthcare (HC) regulatory compliance, M&A, Medicare reimbursement and appeals, hospital pricing, managed care contracting and litigation support. Extensive expert witness experience before the Provider Reimbursement Review Board, ALJ proceedings, civil and criminal litigation, and mediation and arbitration proceedings. Mr. Loria has represented hospitals, nursing facilities, home health, hospice, reference laboratory, physician groups, and other providers in Medicare appeals and controversies. During his career he has managed more than 2,000 Medicare disputes and other investigations. He was a Partner in the SW Regional HC practice of PwC. Prior to joining PwC as a Partner, he was the National Director of the Regulatory practice at EY for 10 years. He founded Loria Associates in 2002 and serves as CEO and Managing Director. He has consistently served HC clients on a nation-wide basis and delivered excellent results based on his unique qualifications a...

Somers, Connecticut

Medical Coding, Medical Billing - CPT codes, Bill & Coding, Compliance, Accounts Receivable Reduction, Bill Review, Personal Injury Bill Reduction, UCR pricing, Bill Analaysis

Beth Morgan, President & CEO, is a Certified Professional Coder (CPC) and Compliance Specialist (MCS-P) since 2004. Over the past 20 years she has worked in several areas of the medical profession doing billing and coding for all sorts of providers. Her knowledge and expertise has enabled her to not only reduce provider’s accounts receivables but medical bills by 51%. She has access to a broad base of insurance company policy information, and is an information contributor, to radio and TV shows as well as magazine articles. Medical Bill Detectives reviews medical bills for errors and overcharges, reducing them down to Usual Reasonable and Customary charges, for negotiating discounts on medical bills. We are able to review bills for all 50 states.

New Britain, Connecticut

Medical Billing, Medical Coding - Medical Records Review, Provider Documentation, Medicaid/Medicare, State Regulations/Statutes, Federal Regulations/Statutes, Regulatory Compliance, Healthcare Fraud Investigation, Data Analysis, Data Mining, Payment Integrity, False Claims Act, Fraud Waste and Abuse, Provider Billing Verification

Revenue Integrity and Healthcare Compliance leader with over 18 years of experience in medical auditing, coding, billing, and regulatory compliance. Currently serving as Revenue Integrity Manager at Connecticut Children’s, where I lead initiatives to safeguard revenue integrity, ensure compliance with federal and state regulations, and proactively mitigate organizational risk. Holding certifications as a CPC, CPMA, CDEO, CHC, and CFE, I bring deep expertise in healthcare compliance, risk assessment, fraud prevention, and data analysis. Recognized for driving process improvements, strengthening internal controls, and enabling healthcare organizations to optimize operations while maintaining the highest standards of billing accuracy, compliance, and ethical practice.