healthcare expert witness work in medical coding and billing, usual customary and reasonable cost of care, HIPAA Privacy, HITECH Act, and Affordable Care act require special considerations
ICD-10 Financial Risk Assessments should include an analysis of historical healthcare claims data for one, two, or ideally three retrospective periods. A data quality assessment is essential, making sure that claims are not duplicates, and that they therefore represent unique events. This is particularly important in view of interim billing on hospital claims. It’s very easy to count hospital admissions multiple times from claims data unless you reconcile claims to a single hospital stay.
ICD-10 will drive initiatives such as bundling, as a component of health care payment reform. Therefore reimbursement, and case management and other areas must be viewed in a broader landscape. HIPAA mandates and health care reform impact one another.