William Felix, Md, Msc Aihc Email & Phone Number

Our efforts are dedicated to integrating technological innovations into healthcare systems and medical policy. We collaborate with stakeholders in the medical device, DMEPOS, prosthetics, and medical supplies sectors, guiding them through FDA clearance, product development, and PDAC coding to optimize reimbursement and develop strategic institutional policies.Core Services:* AI Integration and Technological Innovation: Driving the adoption of AI in healthcare, ensuring innovations align with regulatory standards and enhance clinical practices.* DMEPOS and Clinical Policy Leadership: Expertise in developing and refining clinical policies, managing HCPCS Level II coding, and ensuring regulatory compliance.* Utilization Management and Process Optimization: Optimizing utilization management, billing, and documentation processes to boost efficiency, accuracy, and regulatory adherence.* Medicare and Medicaid Audit Proficiency: Guiding teams through audits for Medicare, Medicaid, and private payers, ensuring compliance and accuracy.* PDAC Verification and Product Development: Offering strategic insights during product development, managing PDAC verification, and mitigating coding challenges.* Compliance and Policy Enhancement: Advancing compliance programs, designing effective policies, and ensuring seamless integration within healthcare operations.* Strategic Partnerships and Implementation: Bridging clinical innovation with medicine, converting breakthrough ideas into strategic partnerships, and ensuring successful administrative implementation.

Longwood, Florida, Us

* Lead clinical initiatives, improving patient outcomes and ensuring high-quality healthcare services. * Develop and enforce medical policies, enhancing compliance with healthcare standards and regulations. * Collaborate with providers to promote best practices and adherence to medical standards. * Monitor patient care, identify improvement areas, and implement effective solutions. * Conduct medical reviews and audits to ensure regulatory compliance and best practice adherence.

Orlando, Fl, Us

* Deliver medical lectures and seminars, enhancing student engagement and understanding. * Supervise and mentor medical students in clinical settings, fostering professional growth.

Tallahassee, Fl, Us

* Teach medical courses and mentor students, enhancing their clinical skills and academic performance. * Collaborate with faculty on curriculum development, leading to improved educational programs.

Boston, Massachusetts, Us

* Lead editorial process for clinical guidelines across specialties, ensuring evidence-based content.* Manage content pipeline for timely policy development.* Create processes for developing, maintaining, and communicating medical policies.* Review, update, and document policy revisions, ensuring regulatory compliance.* Provide detailed policy coverage analyses.* Chair the Utilization Management Committee (UMC), ensuring CMS compliance per 42 CFR § 422.137.* Oversee annual reviews of utilization management policies, including prior authorization.* Ensure the UMC includes practicing physicians and specialty representatives.* Document and communicate UM policy decisions, ensuring compliance with NCDs and LCDs.Strategic Development and Team Management:* Manage a team of medical writers, editors, and policy specialists for high-quality policy content.* Provide leadership and direction, fostering a collaborative work environment.* Assist in strategic policy development.* Scope new content projects for timely delivery.Compliance and Reporting:* Ensure compliance with NCDs, LCDs, and federal regulations.* Review client policies and present recommendations.* Provide clinical oversight to ensure high-quality healthcare services.* Develop and implement compliant medical policies and procedures.* Monitor patient care outcomes and conduct reviews and audits.Stakeholder Communication:* Maintain communication with stakeholders to coordinate medical policies.* Gather feedback to align policies with stakeholder needs.* Collaborate to develop evidence-based, regulatory-compliant policies.* Lead the integration of AI and scientific literature into medical policies.* Participate in AI initiatives, developing innovative AI solutions for policy creation.* Implement AI-driven processes to improve efficiency and accuracy in policy development.

Columbia, Sc, Us

* Administrative oversight to the medical staff, analysis of medical review utilization data, research new medical procedures or technology, and act as a resource to providers and internal staff on issues concerning medical policies* Redaction and review of medical policies* Support operations in the form of case review on both medical and regulatory matters* Assist stakeholders in the proper use of the Healthcare Common Procedure Coding System used to identify items of Durable Medical Equipment, Prosthetics, Orthotics, and Supplies for purposes of Medicare billing through Pricing, Coding and Data Analysis* Development of claim adjudication criteria for situations requiring medical judgment* Education of staff and medical community on various aspects of medical policy and program administration* Development and update medical policy in consultation with appropriate regulatory personnel, medical consultants, and professional societies* Development of external relationships with the medical community and serves as liaison between these entities and the contractors* Review of physician and provider practice pattern analysis and other statistical data related to unusual medical service utilization* Research into new or controversial medical procedures and technology

Washington, Dc, Us

* Delivered emergency medical care to veterans, ensuring rapid response and effective treatment *Performed diagnostic tests and procedures, contributing to accurate patient diagnoses * Collaborated with healthcare teams to develop and implement patient treatment plans * Participated in quality improvement initiatives, leading to measurable enhancements in patient care

Altamonte Springs, Fl, Us

* Two-time winner of the Patient Experience Top Performer Award by Press Ganey (2016 & 2018).* Sports and Orthopaedic Medicine Physician with a focus on Exercise Physiology.* Medical Director for Sports Partnerships, including a role as Medical Director for Disney's ESPN Wide World of Sports.* Member of the Service Line Structure, Governance & Patient Engagement Committee.* Clinical Integration Consultant, enhancing healthcare services through strategic initiatives and partnerships.Lakeland Magic, NBA G League - Lakeland, USLead Physician* Supervised team health and wellness, ensuring peak performance and minimal downtime. * Conducted thorough medical evaluations and treatments, reducing injury recovery time. * Collaborated with athletic trainers and healthcare providers to optimize care. * Developed effective injury prevention and rehabilitation programs, enhancing player longevity. * Provided essential medical support during games and training, maintaining player readiness

New York, Ny, Us

* Served as Medical Director for major events including NBA All-Stars, NBA Finals, NBA Global Games, Basketball Without Borders, and the 2012 London and 2016 Rio de Janeiro Summer Olympics.* Co-authored the NBA's Emergency Manual, significantly enhancing emergency response strategies and protocols.* Designed and executed comprehensive medical logistics and event coverage plans, ensuring seamless operations and budget adherence.* Directed and supervised paramedics and emergency medical technicians, ensuring high-quality medical support and readiness during events.

Fairfield, Connecticut, Us

* Medical Director at OrthoFast, a division of OSG, overseeing the development and implementation of medical protocols.

Sports Medicine Physician

Durham, North Carolina, Us

* Provided emergency medical care to patients, improving outcomes through rapid, accurate interventions. * Taught and supervised medical students and residents, enhancing their clinical skills and knowledge. * Participated in emergency response training and drills, ensuring preparedness for critical situations.

Wichita, Kansas, Us

Wichita, Kansas, Us

Atlanta, Ga, Us

Research Assistant/Dengue Fever Project

San Juan, Puerto Rico , Pr

Subspecialty, Primary Care Sports Medicine

Master Of Science - Ms, Artificial Intelligence In Healthcare

Specialty, Emergency Medicine Residency Program

Intership, Emergency Medicine Residency Program

Doctor Of Medicine (M.D.), Medicine

Bachelor Of Science (Bs), Biology, General