Experts witness admitted by Federal and. State Court, and Arbitrators. Medical Billing Expert Witness. Usual Customary and Reasonable charges for cost of care, Affordable Care Act; value-based care / risk-adjustment in Medicare Part C, ACO, HIPAA Expert Witness, Privacy and Security, medical coding, billing, and auditing, qualified health plans, insurance fraud, electronic health record forensic audits in malpractice, billing, and HITECH Act meaningful use of EHRs, antitrust market analysis, ERISA plans, insurance fraud, Medicare Local Coverage Determinations (Medicare LCD)
Health IT Vision
We bring together perspectives on health and medical data, regulations, and economics. We see strategic opportunities in a unique way to bring unparalleled value. Whether building new solutions, determining the validity of trade secrets or patents and intellectual property, our team brings the experience. Our clients include national providers, healthplans, Private Equity Groups, law firms in Merger and Acquisition advisories and more.
Payors & Providers
Regulatory and Risk management Standards consultancy in medical coding and medical billing, contextual meaning of cybersecurity in healthcare such as the intersection with HIPAA Privacy and HIPAA Security, Value-based care, risk-adjustment and risk corridors, MACRA, MIPS. Represented payors and providers in meaningful use audit defense, usual, customary and reasonable charges (
UCR), billing disputes, damages phase of professional liability using Affordable Care Act or fee–for–service cost, Clinical Documentation Improvement and revenue cycle analytics analytics, fraud analytics.
Merger & Acquisition diligence in Health IT including: cloud computing, HIPAA disclosures, EHR, electronic claims processing, mobile health, Software as a Service (SaaS), single sign on, claims systems, EDI support for Medicare administrative contractors, Third Party Liability, Third Party Administrators, revenue cycle analytics and more. Visibility into $4 billion in MA transactions to date across Medicare, private payor, hospital, home health, skilled nursing, laboratory, diagnostic imaging, pharmaceuticals.
Fully forty percent (40%) of the world’s health research in first world countries is funded by publicly funded and philanthropic funding organizations . Such organizations play a central role in the development of innovation and knowledge development in fields such as bioinformatics and bioethics, pharmaceuticals, medical devices, and innovative gene therapies. Health data is complex. Our team of clinical, biomedical informatics and bioethics experts can act as interpreters between complex data sets and knowledge that can be used to make better philanthropic decisions.
HIPAA Privacy and Security, HITECH Act safeguards. Anti-trust, computer assisted coding, ICD-10, clinical data economic impact
Engagement with VC and private equity. Health IT investor diligence, venture capital, private equity firms, health plans and providers, regulatory impacts
Mobile health solutions.
Customer validation, strategic partners
Government health plan. ICD-10 Usual, customary and reasonable (UCR) cost of medical care
ICD-10 Usual, customary and reasonable (UCR) cost of medical care. Risk adjustment, RAF scores, HEDIS® 5-Star Ratings
Healthcare IT investor diligence. St. Louis health plan, physician group, healthcare IT portfolio investor diligence in accountable care
Do you have questions about health care regulations, data, or health economics?
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