Medical Billing Expert Witnesses

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Medical billing expert witnesses practice in a variety of fields, including healthcare administration, medical coding, health insurance, medical records review, and healthcare compliance. Some of the most common specialties among medical billing expert witnesses also include Medicare/Medicaid billing, hospital billing, ambulatory surgical center billing, physician billing, and emergency medicine billing. They can opine on the effects of fraudulent billing practices, improper coding, non-compliance with insurance regulations, overcharging patients, and discrepancies in medical records.

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Agnes Mary Grogan, BS, RNView profile

ID: 136862

Ms. Agnes Mary Grogan, BS, RN

Ms. Agnes M. Grogan has over 50 years of experience as a Registered Nurse and over 35 years of experience as a Legal Nurse Consultant. She earned her AA from Mount San Antonio College and her BS in Business Administration from California Coast University. Today, this expert is licensed as a Registered Nurse in the state of California. Formerly, she served as a Risk Control Consultant at ACRA, as...

Medical Billing and Consulting Expert Witness | MarylandView profile


Medical Billing and Consulting Expert Witness | Maryland

This qualified expert has over 17 years in healthcare administration, medical accounts, and medical billing matters. She received both an A.A. and B.S. in Health Care Administration from the University of Phoenix. Her previous positions include managerial positions in medical billing departments at various companies including Johns Hopkins, GE Healthcare and LifeBridge Health. She currently works...

Tamera Gayle Rockholt, BSN, RNView profile

ID: 6627805

Ms. Tamera Gayle Rockholt, BSN, RN

Ms. Tamera Gayle Rockholt has 27 years of experience in Nursing. She earned her BSN from Oregon Health and Science University. Today, this expert is licensed as a Registered Nurse in California and Oregon. Formerly, this expert served as a Co-founder and Nurse Consultant at Medical Management Online, as a Founder and Nurse Consultant at Health Cost Management, and as a Nurse Consultant at...

Medicare Rules and Regulations Expert Witness | IllinoisView profile


Medicare Rules and Regulations Expert Witness | Illinois

This board certified physician is currently an active consultant in medical billing compliance, device and drug marketing, and claims data analysis. He has recently been involved as consultant and expert witness in Medicare criminal and civil litigation, Qui Tam cases and administrative hearings. The expert recently served as a Medical Consultant for ICD-10 transition, coding, and policy at...

Geoffrey Dean Bretches II, CMPE, CSMC, FHFMAView profile

ID: 6669841

Mr. Geoffrey Dean Bretches II, CMPE, CSMC, FHFMA

Mr. Geoffrey D. Bretches II has 30 years of experience in Medical Billing and Coding. He earned his BA in Finance and Mathematics from the Vanguard University of Southern California. Today, this expert is certified as a Certified Specialist Managed Care and Certified Healthcare Financial Professional by the Healthcare Financial Management Association and as a Certified Medical Practice Executive...

Medical Billing Expert Witness | CaliforniaView profile


Medical Billing Expert Witness | California

This highly qualified expert has 35+ years of experience in the healthcare arena ranging from hands-on clinical to the executive level of operations. He specializes in medical billing, collections, and in the financial performance of businesses, along with business practices. He received his BSN degree from Arizona State University and his MBA degree in finance from the University of Southern...

Nancy Elizabeth Fraser Michalski, BSN, RNView profile

ID: 6705382

Ms. Nancy Elizabeth Fraser Michalski, BSN, RN

Ms. Nancy Michalski has 41 years of experience in the fields of Registered Nursing and Medical Billing and she earned her BSN from the University of Wisconsin Madison. Today, this expert is licensed as a Registered Nurse in the State of California. Formerly, this expert served as the Founder and Chief Executive Officer of Med Legal Consulting Source, Inc. She currently serves as Vice President...

Medical Records Expert Witness | TexasView profile


Medical Records Expert Witness | Texas

This expert in EMR and Hospital Billing systems has worked as a certified Epic consultant with various healthcare providers for the past 7 years. He is currently certified in 10 Epic applications ranging from hospital billing to CDM and ASAP. He has previously held positions as a Senior Epic Consultant at multiple hospitals, as an Epic Instructional Designer, and as an Epic Revenue Cycle Report...

Mary R. Rossi, CPC, LNCC, RNView profile

ID: 6765522

Ms. Mary R. Rossi, CPC, LNCC, RN

Ms. Mary Rossi has 31 years of experience in Nursing, specializing in Legal Nurse Consulting, She earned her BA in Political Science and Government from the Catholic University of America and her ASN from Waukesha County Technical College. Today, this expert is certified as a Professional Coder by the American Academy of Professional Coders and as a Legal Nurse Consultant by the American Legal...

Medicaid Regulations Expert Witness | IndianaView profile


Medicaid Regulations Expert Witness | Indiana

This highly qualified expert earned his BA in political science from Ohio State University. He then went on to serve as a mediator for consumer protection at the Office of the Indiana Attorney General. He also served as the Director of Medicaid contract management, the director of Provider Relations for Indiana Medicaid and as the Medicaid Program Integrity Director at Indiana Family and Social...

Natalie LopezView profile

ID: 6894955

Mrs. Natalie Lopez

Mrs. Natalie Lopez has 13 years of experience in Medical Billing and Coding. Formerly, this expert served as a Supervisor and Registrar at HCA Healthcare, and as a Coordinator and MOR III at BayCare Health System, and as a Coding Specialist at Prizm, LLC.

Life Care Planning, Medical Cost Projection, & Medical Bill Review Expert Witness | NevadaView profile


Life Care Planning, Medical Cost Projection, & Medical Bill Review Expert Witness | Nevada

This highly qualified expert has been in the field of nursing for over four decades, with demonstrated experience in the areas of life care planning, medical cost projection, Medicare set asides, medical damage reports, and medical bill reviews. She received her BSN from Saint Olaf College and then her MS in nursing from Ohio State University. She is a registered nurse, as well as a certified...

Nadine Larrea GonzalezView profile

ID: 6935984

Ms. Nadine Larrea Gonzalez

Ms. Nadine L. Gonzalez has 23 years of experience in Medical Billing and Coding. She earned a certificate in Documentation Coding from St. Philip's College. Formerly, this expert served as a Coder and Trainer at HealthCare Resolution Services, Inc., and as a Senior Compliance Auditor and Specialist in the Institutional Compliance and Privacy Office at UT Health San Antonio. Currently, this expert...

Sandip Jain GuptaView profile

ID: 6935986

Mr. Sandip Jain Gupta

Mr. Sandip J. Gupta has 15 years of experience in Medical Billing and Marketing and he earned his BBA in Marketing from the University of Texas at Austin. Formerly, he served as a Business Intelligence Manager and Reporting Manager for Compass Professional Health Services. Currently, he serves as the Director of Data Services and Market Pricing Intelligence for Alight Solutions.

Medical Billing Expert Witness FAQs

What is the role of a medical billing expert witness in legal proceedings?

A medical billing expert witness provides insight into the complexities of healthcare billing, coding, and regulations. They can testify on fraudulent practices, incorrect billing, or disputes between providers and insurers.

What types of cases might require a medical billing expert witness?

Cases involving health insurance fraud, wrongful denial of insurance claims, personal injury claims, malpractice suits, or any case where medical costs are disputed may benefit from a medical billing expert witness.

How can a medical billing expert witness help in a healthcare fraud case?

They can analyze patient records, invoices, and payment histories to identify discrepancies or fraudulent charges. Their expertise can provide crucial evidence in proving or disproving allegations of fraud.

Are there subspecialties within the field of medical billing that an expert witness might focus on?

Yes, some experts specialize in areas like Medicare/Medicaid billing, private insurance billing, hospital or clinic-specific billing practices, or specific types of treatment such as mental health or physical therapy.

Why is it important to have a certified professional in medical coding as an expert witness?

Certified professionals have demonstrated their knowledge and adherence to industry standards. Their certification lends credibility to their testimony and ensures they're up-to-date with current practices.

How does Expert Institute select its Medical Billing expert witnesses?

Expert Institute offers a personalized approach to help you find the highest quality experts. We source actively-practicing professionals who match all your requirements for specialty areas, work experience, litigation history, fee range, certifications, location, and more.

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