RN, MEDICARE, MEDICAID CERTIFIED PROFESSIONAL CODER EXPERT WITNESS

EDUCATION

Expert 2223 is a graduate of St. Luke's School of Nursing in Sioux City, Iowa. She has twenty years of healthcare experience ranging from a Renal Dialysis head nurse to a Medicare Fraud Manager. She is a certified professional coder.

During the past twelve years Expert 2223 has assisted physicians, hospitals and clinics with being pro active in accurately coding and billing services to Medicare and Medicaid. This pro active consulting has assisted medical providers with minimizing fines, penalties and over payments during Medicare audit, Medicaid audit and third-party payer audits.

She has experience with a wide range of providers including:

Physician clinics
Home Health agencies
Multi specialty clinics
Teaching facilities
Billing Companies
Universities
Physical Therapy

In addition, Expert 2223 has assisted providers during criminal and civil actions as an expert witness and investigator for the plaintiff and defense during Medicare audit and Medicaid audits. She has developed a strong reputation for litigation support. She has provided consulting services to The Department of Justice on Medicare and Medicaid criminal cases.

Expert 2223 has been a frequent speaker to many organizations through out the country regarding coding, medical record documentation, and government compliance and HIPAA regulations. The Office of Inspector General awarded her the Superior Achievement Award for combating Fraud. Expert 2223 is a member of the American Academy of Professional Coders.

EXPERIENCE

February, 1998 to the present Britton & Associates LLC

Consulting with physician practices, hospitals, billing organizations, home health agencies and The Dept. Of Justice.

General areas of work:
Medicare and Medicaid compliance audits including interpretation of Medicare and Medicaid regulations, Part B;
Coding & documentation audits;
Expert witness for prosecution and or defense involving criminal and civil cases;
Analyze physician operations.

February 1997 to February 1998 McGladry & Pullen CPA
Same responsibilities as above (dept was eliminated)

February 1993 to January 1997 Charles Bailly & Co. CPA
Same responsibilities as above

February 1988 to February 1993 Seim, Johnson, Sestak & Quist CPA
Same responsibilities as above

December 1980 to February 1988 Blue Cross of Iowa & BCBS of Western Iowa & SD
Manager Medicare B Medical Review (3 years)
Implementing Medicare guidelines
Drafting Medical Review policies & procedures
Oversee all pre- pay and post- pay audits
Provider education concerning Medicare Part B regulations
Assist with drafting claims processing internal audits & edits
Develop provider policies for new Medicare regulations
Develop and refer criminal cases to the OIG
Expert witness during trial for non compliance of Medicare rules

Part A Medical Auditor (5 years)
Audit all hospitals in South Dakota & half of Iowa for Part A Medicare compliance
Audit Nursing Homes & Home Health agencies in South Dakota for Part A compliance
Provide education to hospitals, nursing homes & home health agencies
Conduct home visits to determine patient eligibility for Part A coverage
Develop and refer potential fraud cases to the OIG for prosecution
Expert witness during trials for non compliance of Medicare rules

January 1976 to December 1980 Marion Health Center
Head Nurse Renal Dialysis (4 years)
Floor nursing (surgery)

April 1975 to January 1976 Indian Hills Nursing Home
Aide and student nurse
Patient care
Pass medications
Patient treatments
Develop plan of care for new patients

KEYWORDS

Nurse Expert Witness, Registered Nurse Expert Witness, Medicare Fraud Manager Expert Witness, Certified Professional Coder Expert Witness, Medicare Expert Witness, Medicaid Expert Witness, Medical Record Coding and Billing Expert Witness, Pediatric Expert Witness, Home Health Expert Witness, Billing Companies Expert Witness, Renal Dialysis Expert Witness, Reasonableness Professional Fees Expert Witness, Reasonable and Customary Fees Expert Witness

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