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30 years of employment in a community hospital advancing to the executive level as the organizations Chief Nursing Officer. Lead the organization to successful state and JCAHO surveys, knowledge of patient care and medical staff standards. Authored organizational policies and procedures in accordance with best practices. Oversight of 500 FTEs to include nursing and allied support staff for clinical care departments. Provided oversight administration for a long term nursing facility associated with the organization. Participated in CMS surveys. Actively worked with risk management and quality Improvement processes. Knowledge of HR policies and practices to include implementation and enforcement. Developed and implemented the entire operational process for a start up free medical community.
Nurse Administrator, An outpatient community clinic in GA
Bachelor of Science (BS), DeVry University
Sharpsburg,
Georgia
This highly-qualified expert has nearly three decades of experience in the field of geriatric and long term skilled care nursing. She earned her BSN from American Sentinel University, her MSN from Maryville University, and her DNP from Walden University. She is board certified in gerontological nursing, certified in long term care administration nursing, and is a licensed registered nurse. She is active in her field as a member of several professional organizations, including the American College of Healthcare Executives and the Gerontological Advanced Practice Nurses Association. This expert was formerly the assistant director of health services and then was promoted to the director of health and nursing services at a PruittHealth Corporation long term care facility. She then went on to become the director of nursing, first at Southland Health and Rehab and then at Golden Living, where she was responsible for both acute and long term care, before serving as the ambulance clinic clinical nursing manager at Grady Memorial Hospital. Currently, this expert is a clinical instructor at a state college in Georgia and a director of nursing, in charge of acute care, long term care, and rehabilitation, at a large long term residential care facility in Georgia.
Director, A Medical Center in GA
Doctor of Nursing Practice (DNP), Walden University
Ellenwood,
Georgia
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What Can a Medicare Expert Witness Opine On?
Annual Wellness Visit
Comprehensive evaluation of health risks.
Preventive Screenings
Tests for early disease detection.
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Immunizations to prevent illness.
Chronic Disease Management
Ongoing care for chronic conditions.
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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.