Medical Billing Expert Witnesses in Maryland

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...

Woodstock, Maryland

Medical Billing - Medical Billing, Skilled Nursing Facility, Acute Care Hospital, Inpatient Reimbursement, Outpatient Reimbursement, Insurance Contracts, Payer Contracts, Physician Reimbursement

Khalida S. Burton, MBA, FHFMA, CRCE, CRCR, is a Director with Kohler HealthCare Consulting and has over 25 years of revenue cycle, finance and reimbursement, compliance and internal audit, corporate integrity agreement, and independent review organization support, due diligence, and litigation support. Ms. Burton’s revenue cycle experience includes front-end patient access (registration, insurance verification, etc.), charge master, charge capture and compliance, and back-end patient financial services (pre-billing, billing, collections, cash posting and reconciliation, denial management, etc.). Ms. Burton has experience working with medical practices, hospitals, large health systems, faculty practice plans, continuing care retirement communities, skilled nursing facilities, home health agencies, medical device manufacturers/suppliers, and law firms. Clients benefit from her in-depth understanding of healthcare regulations, revenue cycle, reimbursement, managed care contracting, bu...