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Medical Coding Expert Witnesses

The SEAK Expert Witness Directory contains a comprehensive list of medical coding expert witnesses who testify, consult and provide litigation support on medical coding and related issues. Medical coding expert witnesses and consultants on this page may form expert opinions, draft expert witness reports, and provide expert witness testimony at deposition and trial. The issues and subjects these medical coding expert witnesses testify regarding may include: Medical Billing, Medical Coding, Medicare, Coding, Independent Medical Examinations, Medical Necessity, Qui Tam, Ucr, Billing, Causation, Compliance, Disability Evaluation, False Claims Act, Health Insurance Coding, and Health Insurance Fraud.

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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Joe Carnes

Medical Billing Expert Witness

Medsurity Experts

Birmingham, Alabama

Medical Billing, Medical Coding - Usual customary reasonable charges, damages, fraud, Over-billing statistical analysis, Electronic health records, clinical documentation, insurance coverage determinations, provider, biller, insurance disputes

Two decades of Medical Billing expertise in multiple care settings. 24-hour turnaround on billing consultations. Thorough analysis and reporting. Expert in analysis of contract rates compared to actual billed charges Patents trade secrets, electronic medical records, Medicare fraud, medical billing fraud, qui tam false claims act fraud Usual Customary Reasonable (UCR), Meaningful Use Electronic Health Records, HITECH Act, Affordable Care Act, Medicare Advantage, Medicaid,insurance, CRPS, EMTALA, HIPPA compliance

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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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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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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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Richard F Lacy, MHA, CPC, FMC

Medical Coding and Reasonable Value Expert

Transparency Healthcare

Parker, Colorado

Medical Billing, Medical Coding - Reasonable Value of Medical Services, Payment Disputes, Future Cost of Care, Managed Care, Reimbursement Rate Expert, Contract Rate Negotiations, Medical Claims Analysis, Cost Projections

I am the founder of Transparency Healthcare, LLC and serve as an independent medical billing and coding expert. I hold a Master of Health Care Administration (MHA) from Trinity University and a Bachelor’s degree in Psychology from Southern Methodist University. I am a Certified Professional Coder (CPC) through the American Academy of Professional Coders and a Certified Forensic Medical Coder through the Association of Forensic Medical Coders, and I maintain active involvement in multiple professional organizations related to medical billing, coding, and claims analysis. Throughout my career, I have worked extensively with complex healthcare data, large claims datasets, and multiple healthcare information systems to support financial analysis, contract evaluation, and operational improvement. My expertise includes reimbursement methodologies, managed care contracting, utilization analysis, and medical coding compliance. As an expert consultant, I have prepared numerous reports addr...

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Marjorie Hackett-Wallace, CFE, RHIA, CHC, CPIP, CPC, CPMA, CDEO, AAPC Fellow

Healthcare Coding and Documentation Professional

Integrity Medical Billing Consultant

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

I provide expert witness services in healthcare billing, coding, and clinical documentation, supported by over 19 years of industry experience across provider, payer, and compliance environments. My work focuses on the evaluation of medical records, coding accuracy, documentation integrity, and regulatory compliance, including alignment with federal, state and commercial payer requirements. I hold a Master of Legal Studies in Health Law, which strengthens my ability to analyze healthcare documentation within legal and regulatory frameworks and to clearly articulate findings in both written reports and testimony. I maintain multiple nationally recognized certifications, including Certified Professional Coder (CPC), Certified Professional Medical Auditor (CPMA), Certified Documentation Expert Outpatient (CDEO), Certified in Healthcare Compliance (CHC), Certified Fraud Examiner (CFE), and Registered Health Information Administrator (RHIA). My expertise includes auditing evaluation an...

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BETH MORGAN, CPC, MCS-P

Medical Bill Reviews

Medical Bill Consultants, LLC

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.

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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, Medical Billing - 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, Florida Tort Reform Act, Medical Billing, Ophthalmology

ABOUT: Highly experienced expert witness with 150+ 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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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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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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Matthew K. Turner, MD, CCDS

Clinical Validation & DRG

TCD Consulting, LLC

Roseville, Minnesota

Hospitalist, Medical Coding - clinical validation, DRG validation, inpatient versus observation, hospital reimbursement, physician advisor, CDI, diagnosis denial, documentation adequacy, utilization management, auditor denials, AKI, malnutrition, acute respiratory failure, encephalopathy, sepsis, CDI query compliance, level of care, DRG reassignment

Matthew K. Turner, MD, CCDS is a board-certified internal medicine physician, actively practicing hospitalist, and physician advisor who serves as system medical director for clinical documentation integrity (CDI) in a large integrated health system. His work centers on clinical validation, DRG validation, documentation adequacy, level-of-care determinations, and payer or auditor disputes involving hospital reimbursement. Since 2020, Dr. Turner’s work has included both CDI and utilization management physician-level review. In his CDI leadership roles, he has performed more than 500 physician-level clinical validation reviews involving provider-disputed queries, escalations, and prospective query appropriateness consultations; reviewed more than 100 auditor-initiated diagnosis denials since 2022 in which denial of a specific diagnosis typically resulted in DRG reassignment and reduced reimbursement; and prepared written clinical justifications and participated in peer-to-peer discus...

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Richard F Lacy, MHA, CPC, FMC

Medical Coding and Reasonable Value Expert

Transparency Healthcare

Missouri

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Victoria Morgan, FHFMA

Abacus Analytics

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...

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Mark L Friedman, MD, FACEP, FACP

Medical billing and coding expertise

Medical Directions LLC

Newbury, New Hampshire

Medical Billing, Medical Coding - ALL STATES, Medical Billing, Coding, Usual and customary, reasonable and customary, DRG, CPT, ICD-10, ICD-9, medical necessity, fees, fee schedule, billing

Mark L Friedman MD FACEP FACP is currently Chief Medical Officer Emeritus of First Stop Health. He is an emergency physician emeritus at St Vincent’s Hospital in Bridgeport, CT. He was formerly Associate Professor of Emergency Medicine at the Frank Netter School of Medicine, Chief of Emergency Medicine at St Elizabeth's Hospital of Boston, Assistant Professor of Medicine at Tufts University School of Medicine, Assistant Clinical Professor of Emergency Medicine at the University of Illinois, and Adjunct Professor of Public Health at Benedictine University. Dr. Friedman is an expert in DRG claims analysis and medical cost containment. He has helped design programs to prevent medical errors as well as malpractice litigation. He has served as an advisor to government on medical billing fraud and abuse and developed two companies that perform audits for the Medicare RAC. Dr. Friedman is the author of articles and books on medically related topics. Dr Friedman specializes in expert op...

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