Medical Billing Expert Witnesses in Nevada

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...

Las Vegas, Nevada

Pain Management - Medicine, Medical Billing - Usual and Customary Billing, Medically Necessary Billing, Causation, Anesthesiology, Opioids, Pain Management, Overdose, Medication Overdose, Addiction, Airway, Legal Medicine, Reasonable Medical Billing, Soft Tissue Injury, Pre-Existing Conditions, Obstructive Sleep Apnea, Oversedation, Respiratory Arrest, Cardiac Arrest, Code Blue

Expert has extensive experience in analysis of medical billing. Expert is able to determine whether medical and health care bills are usual, customary, reasonable, medically necessary, and related to the incident or accident in question. All specialties and all States and geographic locations. Expert has broad general medical experience including primary care, pain medicine, addiction medicine, surgery, critical care, perioperative medicine, etc. Special interest in opioids, benzodiazepines, sedation, anesthesiology, obstructive sleep apnea, oversedation, respiratory arrest, cardiac arrest, chronic pain, acute pain, and wrongful death. Expert also has experience in paramedical and ancillary medical billing including PT, laboratory, rehabilitation, diagnostic imaging, emergency medical services, ambulance, diagnostic testing, etc.

Reno, Nevada

Medical Billing, Medical Coding - Medical Cost, Healthcare Finance, Revenue Cycle Management

EXPERIENCE: Tahoe Forest Health District, Truckee, CA: June 2018 to Present – Director, Revenue Cycle Projects Responsible for coordination of all revenue cycle functions for 2 hospitals, a cancer center, surgery center, skilled nursing facility, hospice and 150 providers in various clinics in 2 states. Provide management oversite to systems development, charge description master (Revenue Integrity), business office, health information management, patient registration, and customer service. Facility uses both EPIC Hospital Billing (HB) and EPIC Physician Billing (PB) Abacus Analytics: Revenue Analyst/Expert Witness: June 2017 to Present Working as in independent reviewer / expert witness on 3rd party liability medical cases. Principal, Independent Revenue Cycle Consultant: 1991 - Present Consulting projects involve interacting with internal staff in all facets of the revenue cycle. Typical projects include focusing on operational assessments and issues involving staff. Emphas...

Nevada

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...