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This extremely qualified expert with licensed nursing home administrator with years of experience in the field. She received both her B.Ed. and M.Ed. degrees from the University of Toledo and completed her post-graduate training in healthcare and business administration at the University of North Carolina, the University of Toledo and Ashland University. She had fellow status at the American College of Healthcare Administrators and a member of several other professional associations. She is a former executive nurse at Mississippi State Hospital and a former long term care consultant at Omnicare Westhaven. She is also the former nursing home administrator and director of nursing a The Ohio Veterans Home and the former Director of the critical care and post anesthesia units at Firelands Community Hospital. Currently, she works as a Hospital, Nursing Home and Behavioral Health Surveyor for a major healthcare accreditation company.
Hospital Surveyor, A Major Healthcare Accreditation Company
Postgraduate (PG), Ashland University
Waterville,
Ohio
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 PricewaterhouseCoopers; he now runs his own consulting business and assists clients with all areas of Medicare coverage and billing.
Consultant, A private medical billing consulting business
Doctor of Medicine (MD), University of Illinois Abraham Lincoln School of Medicine
Chicago,
Illinois
This expert has extensive credentials and training in nursing, nurse life care planning, and medicare consulting. She belongs to the American Association of Legal Nurse Consultants, the American Association of Nurse Life Care Planners, and the National Association of Medicare Set-Aside Professionals. She has held numerous nursing positions throughout the mid-west and is currently a nurse life care planner and consultant at a private firm in Indiana.
Nurse Life Care Planner and Consultant, A private consultancy
Bachelor of Science in Nursing (BSN), University of Phoenix School of Nursing
Muncie,
Indiana
This highly qualified expert has 36 years of experience as a skilled care nursing facility director and attending physician. After earning his BS from Illinois State University and his MD from the University of Illinois, he completed a residency in family medicine at the University of Illinois. He also went on to earn his MBA from the Isenberg School of Management at the University of Massachusetts. This expert is board certified in family medicine with a specialization in geriatrics. He is also a fellow with the American Academy of Family Physicians and on the board of directors for the American Association for Physician Leadership. Among his former roles, he served as the medical director at four nursing homes in Illinois: Prairie View Nursing Home, Basswood Nursing Home, Colonial Hall, and Greenfield Retirement Home. Currently, this expert is the chief medical officer for a rural community care organization in Illinois as well as the medical director for a community care alliance in Colorado.
Chief Medical Officer, A rural community care organization in IL
Master of Business Administration (MBA), University of Massachusetts
Illinois
This licensed registered nurse has over 25 years of experience in nursing, including the fields of medical-surgical, hospice, and community health. She earned her AS from Saint Luke's School of Nursing and her BS in nursing from the University of Missouri-Kansas City. Along with being licensed in Missouri and Kansas as a registered nurse, she is also a certified nurse life care planner and a member of the American Association of Legal Nurse Consultants. Formerly, she has held a number of nursing positions, including a community and employee health nurse at Clay County Public Health Center, a medical-surgical bedside care nurse at the Kansas City VA Medical Center, and a general medical-surgical nurse for Favorite Healthcare Staffing Services. She has also served as a nurse analyst for Shook, Hardy, and Bacon Lawfirm. Currently, she is a special health care needs service coordinator for a state department of health and senior services as well as a legal nurse consultant and nurse life care planner for a nursing consultancy in Missouri.
Legal Nurse Consultant, A nurse life care planning and consulting service in MO
Bachelor of Science (BS), University of Missouri-Kansas City
Liberty,
Missouri
This highly qualified expert has 40 years of experience in nursing, and she specializes in wound care and geriatrics. She obtained her BSN from Temple University, before beginning her career in the field. Today, she is a licensed registered nurse in the state of Illinois and a certified wound care nurse. This expert previously served as a registered nurse at Summit Home Health Inc., Applied Home Telemedicine, ENH Home Services, and Amita Health Saint Joseph Hospital, as well as a wound care nurse at the Bethany Terrace Nursing Centre. She is currently a registered nurse at a geriatrics health care company in Illinois, where she provides comprehensive healthcare and wound care assessments to senior patients.
Registered Nurse, A Geriatrics Health Care Company in IL
Bachelor of Science in Nursing (BSN), Temple University
Chicago,
Illinois
This highly-qualified expert has over 20 years of experience working in long-term care. She earned her BSN from Kent State University, is a licensed registered nurse, and holds an additional certification in wound care. She began her career as a staff nurse at Euclid Hospital before serving as a charge nurse, a nurse supervisor, and unit coordinator at Menorah Park Campus. She then served as the director of nursing at Chardon Healthcare Center, Mapleview Country Villa, and the Greens. Currently, this expert is the director of nursing at a long-term care skilled nursing and rehabilitation facility in Ohio, where her responsibilities include coordinating care and ensuring quality and safety for residents.
Registered Nurse, A medical center and a rehabilitation center in OH
Bachelor of Science (BS), Kent State University
Fairport Harbor,
Ohio
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What Can a Medicare Expert Witness Opine On?
Annual Wellness Visit
Comprehensive evaluation of health risks.
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FAQs for Medicare Expert Witnesses
What is a medicare expert witness?
A Medicare expert witness is a healthcare or billing professional who explains Medicare rules and standards in legal cases. They assist by reviewing records, analyzing billing, and testifying to clarify Medicare compliance issues.
What types of cases may benefit from the insights of a Medicare expert witness?
A Medicare expert witness supports fraud, billing, reimbursement, coverage denial, medical necessity, compliance, overpayment, and False Claims Act litigation cases.
How can a Medicare expert witness assist with interpreting CMS regulatory guidance?
A Medicare expert witness can clarify complex CMS regulatory guidance, explain how rules apply to specific cases, and support compliance or dispute resolution in court.
What qualifications should attorneys require from a Medicare expert witness?
Attorneys should require a Medicare expert witness to have clinical or billing experience, CMS regulatory expertise, relevant certifications, and prior credible testimony in Medicare cases.
How does a Medicare expert witness evaluate billing and reimbursement disputes?
A Medicare expert witness evaluates billing and reimbursement disputes by reviewing medical records, coding, claims data, and Medicare regulations to assess compliance and payment accuracy.
What is Expert Institute’s process for selecting medicare expert witnesses?
Expert Institute delivers a tailored approach to connect you with top-tier experts. We identify actively practicing professionals who meet your exact criteria for specialty, experience, litigation background, fee structure, credentials, location, and more.