Managing Partner, Expert Witness
Current• Advise investors in Health IT (specialties: cloud, mHealth, claims processing / revenue cycle management, electronic health records, SaaS based analytics, Accountable Care, Value Based Care, Medicare Advantage, healthcare economics diligence) • Advise legal teams in healthcare economics, clinical data and new regulations, structures (expert witness, reasonable and customary costs, pricing, diagnostic imaging (MRI, CPT, etc. anti-trust matters for Federal Trade Commission landmark case in clinical data, ICD-10, reimbursement economics, computer assisted coding, revenue cycle management)• Advise health plans and hospital systems (ICD-10, EDI, ACOs, EHR, Meaningful use, Revenue Cycle, CORE Operating Rules, Affordable Care Act, Medical Loss Ratio)• Advise Health IT companies in mHealth, Cloud, SaaS, BigData, Analytics, 510k diagnostics, social media and healthcare• Presided over explosive growth of a Health IT firm - $50 million in enterprise deals, high profile clients• P&L experience - startup to $50 million to $350 million; managing teams up to 200• Diligence on $4 billion in healthcare M&A with leading payor / provider / HIT target companies• Extensive clinician software usability and workflow expertise, large IT systems migration experience• Filing of three patents in healthcare informatics, mHealth and Cloud focused clinical data and process• Quoted in Wall Street Journal, regular speaker, published works as expert in the field• Manager, largest social media group of its kind on LinkedIn focused on Accountable CareExpert opinions - care claims reimbursement; fraud; HIPAA privacy and security; medical record & billing documentation; ICD & CPT coding for orthopedics, obstetrics and cardiology; Medicare, Medicaid Insurance. Lead of team with MD, RN, RD, MPH, RHIT, CCHIT, CPC credentials bringing more than 30 years of experience in coding, regulatory affairs, population health Medicare Advantage and Medicare Shared Savings Plan (MSSP) ACOs.