Health Insurance Expert Witnesses

The American healthcare industry is valued at $3,504 trillion, with the average citizen spending about $4,342 on healthcare in the year 2017. Health Insurance is insurance coverage that pays for medical, surgical and occasionally dental expenses for the insured. This type of insurance can reimburse the insured for medical expenses they sustained from an illness or injury. Health insurance companies often reimburse the health care provider directly. Individuals can acquire health insurance in different ways. Some individuals receive their health care insurance through their employer as part of their benefits package. Under this method, the employer pays for part of the employee’s benefits and part is deducted from the employee’s paycheck. Individuals can also purchase their health insurance through the Affordable Care Act’s Health Marketplace or directly from a specific insurance company. Medicare and the Children’s Health Insurance Plan (CHIP) are two public health programs. Medicare covers older adults and individuals with certain disabilities. The Children’s Health Insurance Plan covers children from infancy to the age of eighteen, whose parent’s income falls below a certain income limit. The healthcare insurance industry touches many areas of expertise including billing, fraud, misinformation, risk assessment and more. Health insurance experts are often retained in order to lend their expertise to issues related to malpractice, negligence, medical errors, and more. Our health insurance experts have worked as administrators, malpractice consultants, medical staff, doctors, accountants, professors, research professionals, to name a few. These experts specialize in:

• Regulatory compliance
• Corporate governance
• Mergers and acquisitions
• Hospitals
• Banks
• Retail
• Systems development
• Pricing
• Valuation
• Medical necessity
• Claim reimbursement
• Chemotherapy infusion
• Oncology
• Primary care
• Chronic disease management
• Taxation
• Medical malpractice
• Contract disputes

With hundreds of years of combined experience, our health insurance experts have successfully testified for both plaintiffs and defense in a variety of cases and are prolific international authors and lecturers. Their published works span topics that include interpretation, eligibility of athletes, clinical research, secured lending, risk management, forecasting, medical infusion claims, ESA (EPO/DPA), electronic medical records, healthcare software, and hospital operations.