HLN - Experts in Medicare, health insurance, documentation, coding, billing & reimbursement

Have you been searching for experts in medical billing, Medicare or Medicaid

compliance, reasonableness of medical charges, ICD or CPT coding, facility

or professional fee billing, clinical documentation, statistical sampling, medical

or economic damages, health insurance or forensic accounting?

Health Law Network may be your solution. We offer peer-reviewed methodologies and Appellate court proven testimony by experienced professionals who have provided consulting services and conducted audits and investigations for hundreds of hospitals, physicians and other healthcare providers nationwide. HLN's experts have provided expert testimony in administrative and regulatory proceedings, as well as in state and federal courts for civil and criminal cases, for plaintiffs and defendants. We have served in over 500 cases covering 45 states, and have testified as experts in federal and state courts in civil and criminal trials in 22 states.

Health Law Network provides experienced Medical Billing Experts, Reimbursement Experts, Certified Public Accountants, Certified Fraud Examiners, Forensic Accountants, Registered Nurses, Certified Valuation Analysts, Board Certified Physicians, Statisticians, Credentialed Coding Experts, and Medical Record & Health Information Management Professionals. We work with Healthcare Providers and Attorneys nationwide seeking independent investigations, advice by industry professionals, or expert reports and testimony.

HLN's team of consultants have been admitted as experts in healthcare financial management, medical billing and reimbursement, and have had their testimony upheld in multiple state and federal courts.

The United States 11th Circuit Court of Appeals opinion in the Showan v. Krispy Kreme personal injury case (No. 17-15547 issued April 29, 2019) stated,

"Mr. Blount is qualified to testify as an expert on Medicare reimbursement and billing issues. He possesses specialized knowledge, based on his over thirty years extensive experience as a healthcare auditor addressing Medicare reimbursement concerns and through his published works."

U.S. District Court (IL) Judge Amy J. St. Eve's opinion stated, "Mr. Blount's testimony is relevant under Daubert because it helps the trier of fact determine whether Chaudhry should be entitled to a benefit under the Policy—a benefit that is calculated based, in part, on Chaudhry's income prior to his disability."

(Chaudhry vs. Provident Life, Civil No. 12-cv-5838)

“In this case, Blount testified that there is a standard method among hospitals for calculating the reasonable amount of billed charges, and, according to his research, TMC charged rates that were higher than comparable hospitals…. Considering the testimony presented, we conclude that Blount's opinion was both reliable and relevant…. Moreover, the trial court properly concluded that Blount's testimony was relevant. Our Supreme Court has already held that a comparison of charges is relevant to the issue of reasonableness. See Bowden II, supra, 297 Ga. at 296. Thus, Blount's opinions as to the reasonableness of the chargemaster rates are helpful to the trier of fact.”

"Blount’s and Schmor’s testimony did not violate the collateral source rule. Their testimony addressed the reasonableness and necessity of what Showan had paid for her discectomy. Whether the expenses were “reasonable and necessary” is a critical inquiry under Georgia law. ...Accordingly, the district court did not abuse its discretion in admitting the testimony of Blount and Schmor."

State Court of Chatham County (GA) Judge Gregory Sapp's opinion stated, "the Court DENIES the Plaintiffs motion to exclude Mr. Blount's testimony regarding the reasonableness of her medical expenses. The Court finds this testimony might be helpful to the jury and the comparison of charges would be relevant to the jury's determination of reasonableness. (Miller vs. HFW, Civil No. STCV1702110SA)

"The Court finds that Lamar Blount's anticipated testimony is based upon sufficient facts or data that is expected to be admitted at trial, that it is the product of reliable principles and methods, and that he has applied the principles and methods reliably to the facts of this case.... The Court finds that the anticipated testimony does not violate the collateral source rule, and is instead offered to demonstrate whether medical bills were reasonable. Showan v. Pressdee, 922 F.3d 1211 (2019). Accordingly, Plaintiffs Motion is hereby DENIED."

U.S. District Court (CO) Judge Michael Hegarty's opinion stated, " I view Mr. Blount has provided statistical data and demonstrating that, in comparison with other local hospitals, Sky Ridge is out of sync. For the foregoing reasons, Plaintiffs’ [sic] Opposed Motion to Exclude the Opinions of Defendant’s Expert, L. Lamar Blount ... is denied without prejudice." (Chapman v. Target, 19-cv-03240

"The Court finds that based on Blount's testimony is reliable... The Court finds that Blount's testimony would assist the trier of fact. Blount's testimony may give jurors more detailed information in assessing whether Plaintiff's medical bills are reasonable when compared to other similar charges across the spectrum of hospitals and government care in the metro Atlanta area."

"The Court finds further that whether Mr. Blount's opinions are based on reliable principles and methods, the issue is one of credibility as to the reliability of the opinions and is more properly in the province of the jury. Finally, having examined the affidavit of Mr. Blount, the Court finds that the resources applied by him to his analysis of the medical records are not resources which the average juror would be familiar with or possibly even know about. Therefore, the Court finds that the content of these resources is not the type information an average juror would have knowledge of and Mr. Blount's opinions thereon would assist a jury."

"This Court finds that Mr. Ulbrandt's method can be tested and is simply not a conclusory approach. This appears to be the generally accepted method in the scientific community for analyzing the reasonableness of medical procedure and facility charges. This Court therefore finds that Mr. Ulbrandt is a competent expert. His methodology is sufficiently reliable and through the application of his scientific and specialized expertise, his testimony will assist the trier of fact to understand the evidence."

State Court of Douglas County (GA) Judge Eddie Barker's opinion stated, "This Court therefore finds that Mr. Ulbrandt is a competent expert. His methodology is sufficiently reliable and through the application of his scientific and specialized expertise, his testimony will assist the trier of fact to understand the evidence. Therefore, based on the foregoing, Plaintiff's Motion to Exclude the Testimony of Mr. Tony Ulbrandt is DENIED.

(Jackson v. Sargent, Civil No. Case No.19SV0056)

State Court of DeKalb County (GA) Judge Kimberly Anderson's opinion stated, "Plaintiff argues that Mr. Blount’s opinion in this case does not rely on accepted methodology, and therefore the Court cannot deem it sufficiently reliable under Daubert and O.C.G.A. § 24-7-702... Here, the Court finds that Mr. Blount’s testimony satisfies the reliability requirement as his methodology has a sufficient factual basis... Moreover, the Court finds Mr. Blount’s testimony about the reasonableness of Plaintiff’s medical bills is relevant." (Hassan v Kroger, Civil No. 18A68687)