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| National Chairman, Ethics Committee of the American College of Medical Quality, Emergency Medicine and Medical Consulting Services.
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| We consult and write HMO reinsurance, employer stop loss, provider excess loss reinsurance, Broker or agent fiduciary, and audit reinsurance claims. Automatic Facultative, and Quota Share reinsurance policies & treaties....
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| Certified Fraud Examiner. Qualified to testify as an expert witness in Federal and State District Court.
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| A 20 year background in research, development, management, operations and clinical services. A prolific researcher, writer, speaker, and clinician in rehabilitation, health care operations, occupational therapy...
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| 38 hours testifying under oath, Asst Professor at a Medical Center, Consultant, 19 years in healthcare finance.
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| Advice on insurance claim handling practices. Analysis of complex insurance claims. Insurance Litigation support services including expert witness testimony. Advice on bad faith claims.
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| Recognized and powerful leader in the field of healthcare business services, advancing the industry with a focus on revenue enhancement, cost containment and financial benefits through education and improved methodology....
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| over 20 years experience in Medical Claims processing, all the Blues, Tpas and re-insurance carriers. fully insured and self funded
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| EW #13651 is a senior health care executive with experience in health insurance, hospitals, managed care and health administration. He has been recognized nationally as an expert.
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| A team of experts (not a referral svc)doctors, administrators, reimb specialists, health org / health ins expertsmedical & admin malpractice, physician practice, hosp mgmt, Medicare, managed care
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| Looking for a medical insurance reimbursement expert?
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Find Medical Insurance Reimbursement experts and consultants for Medical Insurance Reimbursement litigation support at www.expertwitness.com. Available to be Medical Insurance Reimbursement expert witnesses and provide Medical Insurance Reimbursement forensic consulting in Medical Insurance Reimbursement litigation, in addition prepare Medical Insurance Reimbursement expert witness reports for use in deposition and/or in-court trial testimony.
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Categories To Find "Medical Insurance Reimbursement" Experts:
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CLAIMS |
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A claim is a legal action to obtain money, property or the enforcement of a right protected by law against another party.
Individuals and businesses purchase insurance policies to protect against monetary losses. In the event of a loss, policyholders submit claims, or requests for payment, seeking compensation for their loss. Adjusters, appraisers, examiners, and investigators work primarily for property and casualty insurance companies, for whom they handle a wide variety of claims alleging property damage, liability, or bodily injury. Their main role is to investigate the claims, negotiate settlements, and authorize payments to claimants, all the while mindful not to violate the claimants rights under Federal and State privacy laws. They must determine whether the customers insurance policy covers the loss and how much of the loss should be paid to the claimant. Although many adjusters, appraisers, examiners, and investigators have overlapping functions and may even perform the same job, the insurance industry generally assigns specific roles to each of these claims workers.
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HEALTH CARE MANAGEMENT |
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Managed care is a synonym for PPO, HMO, MCO, and POS.
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Managed care is a concept in U.S. health care which rose to dominance during the presidency of Ronald Reagan as a means to control Medicare payouts. As a major Medicare claims administrator, the Blue Cross-Blue Shield insurance firm was a major architect of managed care. It spread fairly quickly to the health insurance industry in the private sector.
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INSURANCE - GENERAL |
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General insurance policies, including automobile and homeowners policies, provide payments depending on the loss from a particular financial event. General insurance typically comprises any insurance that is not determined to be life insurance, and is called property and casualty insurance in the U.S..
In the UK, General insurance is broadly divided into three areas; personal lines, commercial lines and London market.
The London market insures with large commercial risks, for example insuring supermarkets, football players and other very specific risks.
Commercial lines products are usually designed for relatively small legal entities. These would include workers comp (employers liability), public liability, product liability, commercial fleet and other general insurance products sold in a relatively standard fashion to many organisations.
Personal lines products are designed to be sold in large quantities. This would include autos (private car), homeowners (household), pet insurance, creditor insurance and others.
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MEDICAL LIENS |
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As all healthcare providers know, patients do not always have the present financial ability to cover the cost of their medical bills. In cases involving injury to a patient through the negligence of another, healthcare professionals can employ medical liens to secure payment for their services. Medical liens can be created in two different ways: 1) by contract and 2) by operation of law. This article will briefly touch on contractual liens while focusing on the express statutory language which create liens through the operation of law.
Find MEDICAL LIENS experts and consultants for MEDICAL LIENS litigation support. Available to be MEDICAL LIENS expert witnesses and provide MEDICAL LIENS forensic consulting in MEDICAL LIENS litigation, in addition prepare MEDICAL LIENS expert witness reports for use in deposition and/or in-court trial testimony.
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MEDICARE |
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Medicare is a health insurance program administered by the United States government, covering people who are either age 65 and over, or who meet other special criteria. It was first passed on July 30, 1965 by President Lyndon B. Johnson as amendments to Social Security legislation.
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NURSING HOMES - GERIATRICS |
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A nursing home or skilled nursing facility (SNF) is a place of residence for people who require constant nursing care and have significant Activity of Daily Living (ADL) deficiencies. Residents include the elderly and younger adults with physical disabilities. Adults 18 or older can stay in a skilled nursing facility to receive physical, occupational, and other rehabilitative therapies following an accident or illness. In the US, nursing homes are required to have a licensed nurse on duty 24 hours a day, and during at least one shift each day, one of those nurses must be a Registered Nurse. In April, 2005 there were a total of 16,094 nursing homes in the United States, down from 16,516 in December, 2002. Some states have nursing homes that are considered NF or nursing facility......these homes do not have beds certified for Medicare patients, but can only treat patients whose payments source is Private Pay or Medicaid.
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PHYSICIAN ASSISTANT - PA |
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In the United States, Physician Assistants (PAs) are non-physician clinicians licensed to practice medicine with a physician's supervision. This supervision, in most cases, need not be direct or on site and many PAs practice in remote or underserved areas in satellite clinics. PAs can treat patients and, in most states, prescribe medicine, and in some states in the US they carry a DEA number that gives them authority to prescribe controlled medications like narcotics. PAs in surgical practices also serve as first assists in surgery. PAs provide medical services that are reimbursed under Medicare and third party insurances. Physician Assistants and Nurse Practitioners both provide similar services in most states, the major distinction being that nurse practitioners are registered nurses by trade. Both are also known as Advanced Practice Clinicians (APCs) or mid-level practitioners (MLPs).
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REINSURANCE |
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Reinsurance is a means by which an insurance company (called the reinsured, ceding company or cedant) shares the risk of loss with another insurance company (called the reinsurer).
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WORKERS COMPENSATION |
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Workers compensation systems (workers comp or compo) provide for financial compensation for work-related injuries of employees, in particular compensation of loss of wages, sometimes also for medical costs. These laws are usually a feature of highly developed industrial societies. Employees compensation laws are often only implemented after long and hard fought struggles by trade unions, particularly in early industrialisation. There are often benefits available to dependents of workers killed on the job as well.
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Medical Insurance Reimbursement Experts Witnesses - Medical Insurance Reimbursement Forensic Consultants.
Find Medical Insurance Reimbursement experts and consultants for Medical Insurance Reimbursement litigation support. Available to be Medical Insurance Reimbursement expert witnesses and provide Medical Insurance Reimbursement forensic consulting in Medical Insurance Reimbursement litigation, in addition prepare Medical Insurance Reimbursement expert witness reports for use in deposition and/or in-court trial testimony.
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Medical Insurance Reimbursement
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