Medical Coding Expert Witnesses

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Medical coding expert witnesses practice in a variety of fields, including healthcare administration, medical billing, health information management, compliance, and auditing. Some of the most common specialties among medical coding expert witnesses include ICD-10 coding, CPT coding, clinical documentation improvement, revenue cycle management, and fraud detection. They can opine on the effects of incorrect coding, fraudulent billing practices, impacts of coding errors on patient care, compliance with federal regulations, and the financial implications of medical coding errors.

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Agnes Mary Grogan, BS, RNView profile

ID: 136862

Ms. Agnes Mary Grogan, BS, RN

Ms. Agnes M. Grogan has over 50 years of experience as a Registered Nurse and over 35 years of experience as a Legal Nurse Consultant. She earned her AA from Mount San Antonio College and her BS in Business Administration from California Coast University. Today, this expert is licensed as a Registered Nurse in the state of California. Formerly, she served as a Risk Control Consultant at ACRA, as...

Internal Medicine and Medical Coding Expert Witness | IllinoisView profile

E-708054

Internal Medicine and Medical Coding Expert Witness | Illinois

This board-certified internal medicine and medical coding expert received his BA in zoology from Miami University before earning his MD from Loyola University. He subsequently completed an internal medicine residency at the University of Illinois. He is certified as a professional coder by the American Academy of Professional Coders, and holds additional certifications in advanced cardiac life...

Tamera Gayle Rockholt, BSN, RNView profile

ID: 6627805

Ms. Tamera Gayle Rockholt, BSN, RN

Ms. Tamera Gayle Rockholt has 27 years of experience in Nursing. She earned her BSN from Oregon Health and Science University. Today, this expert is licensed as a Registered Nurse in California and Oregon. Formerly, this expert served as a Co-founder and Nurse Consultant at Medical Management Online, as a Founder and Nurse Consultant at Health Cost Management, and as a Nurse Consultant at...

Medicaid Regulations Expert Witness | IndianaView profile

E-472200

Medicaid Regulations Expert Witness | Indiana

This highly qualified expert earned his BA in political science from Ohio State University. He then went on to serve as a mediator for consumer protection at the Office of the Indiana Attorney General. He also served as the Director of Medicaid contract management, the director of Provider Relations for Indiana Medicaid and as the Medicaid Program Integrity Director at Indiana Family and Social...

Geoffrey Dean Bretches II, CMPE, CSMC, FHFMAView profile

ID: 6669841

Mr. Geoffrey Dean Bretches II, CMPE, CSMC, FHFMA

Mr. Geoffrey D. Bretches II has 30 years of experience in Medical Billing and Coding. He earned his BA in Finance and Mathematics from the Vanguard University of Southern California. Today, this expert is certified as a Certified Specialist Managed Care and Certified Healthcare Financial Professional by the Healthcare Financial Management Association and as a Certified Medical Practice Executive...

Nancy Elizabeth Fraser Michalski, BSN, RNView profile

ID: 6705382

Ms. Nancy Elizabeth Fraser Michalski, BSN, RN

Ms. Nancy Michalski has 41 years of experience in the fields of Registered Nursing and Medical Billing and she earned her BSN from the University of Wisconsin Madison. Today, this expert is licensed as a Registered Nurse in the State of California. Formerly, this expert served as the Founder and Chief Executive Officer of Med Legal Consulting Source, Inc. She currently serves as Vice President...

Mary R. Rossi, CPC, LNCC, RNView profile

ID: 6765522

Ms. Mary R. Rossi, CPC, LNCC, RN

Ms. Mary Rossi has 31 years of experience in Nursing, specializing in Legal Nurse Consulting, She earned her BA in Political Science and Government from the Catholic University of America and her ASN from Waukesha County Technical College. Today, this expert is certified as a Professional Coder by the American Academy of Professional Coders and as a Legal Nurse Consultant by the American Legal...

Natalie LopezView profile

ID: 6894955

Mrs. Natalie Lopez

Mrs. Natalie Lopez has 13 years of experience in Medical Billing and Coding. Formerly, this expert served as a Supervisor and Registrar at HCA Healthcare, and as a Coordinator and MOR III at BayCare Health System, and as a Coding Specialist at Prizm, LLC.

Nadine Larrea GonzalezView profile

ID: 6935984

Ms. Nadine Larrea Gonzalez

Ms. Nadine L. Gonzalez has 23 years of experience in Medical Billing and Coding. She earned a certificate in Documentation Coding from St. Philip's College. Formerly, this expert served as a Coder and Trainer at HealthCare Resolution Services, Inc., and as a Senior Compliance Auditor and Specialist in the Institutional Compliance and Privacy Office at UT Health San Antonio. Currently, this expert...

Sandip Jain GuptaView profile

ID: 6935986

Mr. Sandip Jain Gupta

Mr. Sandip J. Gupta has 15 years of experience in Medical Billing and Marketing and he earned his BBA in Marketing from the University of Texas at Austin. Formerly, he served as a Business Intelligence Manager and Reporting Manager for Compass Professional Health Services. Currently, he serves as the Director of Data Services and Market Pricing Intelligence for Alight Solutions.

Medical Coding Expert Witness FAQs

What is the role of a medical coding expert witness in legal cases?

A medical coding expert witness provides insight into the complex world of healthcare billing, ensuring accurate interpretation of codes and compliance with regulations.

In what types of cases can a medical coding expert witness be beneficial?

Medical coding experts are crucial in healthcare fraud or malpractice cases, insurance disputes, and any case involving healthcare billing discrepancies.

How can a medical coding expert witness help in understanding the complexities of medical billing?

They can decode medical bills, explain standard practices, identify errors or fraudulent charges, and testify on the accuracy of billed services.

Are there subspecialties within the field of medical coding that an expert witness might focus on?

Yes, some experts may specialize in areas like outpatient coding, inpatient coding, or specific fields such as oncology or cardiology coding.

How does a medical coding expert witness's knowledge of ICD-10 impact their testimony?

Their expertise in ICD-10 (the international system for disease classification) ensures accurate interpretation of diagnoses and procedures, which can be pivotal in a case.

How does Expert Institute select its Medical Coding expert witnesses?

Expert Institute offers a personalized approach to help you find the highest quality experts. We source actively-practicing professionals who match all your requirements for specialty areas, work experience, litigation history, fee range, certifications, location, and more.

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