Health Law Network, Inc.

Health Law Network offers expert testimony on issues related to Medicare & Medicaid compliance, clinical documentation, ICD or CPT coding, hospital or professional fee billing, health insurance or quality of care issues. HLN provides access to experienced Reimbursement Experts, Certified Public Accountants, Fraud Examiners, Credentialed Coding Experts, Medical Record & Health Information Management Professionals, Statisticians, Nurses and Board Certified Physicians. We work with Attorneys, Insurance Carriers and Healthcare Providers nationwide seeking independent investigations and advice by industry experts.

Services

Health Law Network consultants' practice expertise includes:

• Accounting
• Antitrust
• APCs
• Billing
• Clinical Documentation
• Compliance Programs
• Contractual Disputes
• Cost Reports
• Damages Quantification
• DRGs
• ERISA
• False Claims
• Forensic Accounting
• Fraud
• HIPAA
• ICD & CPT Coding
• Investigations
• Insurance
• IRO Services
• Managed Care Contracting
• Medical Records
• Medicare & Medicaid
• Physician Services
• Practice Assessments
• Professional Standards
• Rate Setting
• Quality of Care
• RAC & ZPIC Audits
• Self Disclosure
• Statistical Sampling
• UCR Charges
• Valuations

Health Law Network was founded by Lamar Blount, the co-author of the American Medical Association's second and third edition best selling "Mastering the Reimbursement Process" book. The mission of HLN is to assist attorneys and those involved in the healthcare industry in their search for experienced professionals qualified to serve as:

• - Independent Investigators
• - Compliance Consultants
• - Expert Witnesses
• - Consultants to Legal Counsel

Health Law Network brings together the range of special talent needed to address most cases involving concerns about proper reimbursement, adequacy of clinical documentation, accuracy of coding and quality of care, as well as allegations of false claims, Medicare or Medicaid fraud, antitrust violations and more. Health Law Network professionals include:

• - Certified Public Accountants (CPA)
• - Certified in Financial Forensics (CFF)
• - Certified in Healthcare Compliance (CHC)
• - Certified Evaluation and Management Coder (CEMC)
• - Certified Forensic Interviewer (CFI)
• - Certified Fraud Examiner (CFE)
• - Certified Health Care Auditor (CHCA)
• - Certified Professional Medical Auditor (CPMA)
• - Certified Valuation Analyst (CVA)
• - Credentialed Coding Experts (CCS, CPC-H and CPC-P)
• - Facility Coding Specialist (FCS)
• - Masters in Health Administration (MHA)
• - Medical Record & Health Information Management Professionals (RHIA and RHIT)
• - Professional Coding Specialist (PCS)
• - Radiology Certified Coder (RCC)

Litigation Support Services

Health Law Network has served in over 200 cases, and our consultants have been admitted as an expert in multiple US District Courts and State Courts in the fields of Medicare & Medicaid reimbursement, healthcare finance, and other related areas. Additional services available include medical case reviews, case law research, and background checks on expert witnesses.

Areas of Expertise

• Accounting
• Ambulance
• Ambulatory Surgery
• Business Valuations
• Chiropractic
• Commercial Litigation
• Criminal
• Economic Damages
• Economic Losses
• Emergency Medical Services (EMS)
• ERISA
• Financial Analysis
• Fraud
• Health Care Plans

• Healthcare
• HMO
• Home Healthcare
• Hospital Administration
• Hospital Records
• Insurance Health
• Insurance Life
• Insurance, Bad Faith
• Investigation
• Legal Nurse Consultant
• Long Term Care
• Lost Profits
• Managed Care Plans
• Medicaid

• Medical Malpractice
• Medical Records
• Medical Review
• Medicare
• Nurse Anesthesia
• Nursing Home
• Personal Injury
• Professional Responsibility
• Quality Assurance
• Rehabilitation
• Statistics
• Valuation
• White Collar Crime

Additional Expertise:

E/M Coding, ICD/CPT Coding, IRO Services, False Claims, Reasonable Charges.

Profile

Representative Engagements:

Assisted law firm representing one of the largest national home health chains to amend over 200 Medicare cost reports and recover over $2 million in additional reimbursement.

Performed strategic operational review for a 200 bed hospital, identified and prioritized key objectives for the Board and CEO, provided an outsourced Compliance Officer, and implemented a DRG Documentation & Coding Improvement Plan.

Developed self disclosure process for 12-hospital group, audited over 1,000 Medicare claims, and statistically determined overpayment settlement.

Assisted law firm representing one of the largest hospital chains in rebutting an insurance carrier's allegations of unbundled charges and charges not allowed by Medicare for PPO patients.

Assisted law firm representing one of the largest national HMO providers in defending against allegations of improper payments and recovering overpayments.

Calculated economic damages and served as advisor to law firm defending a national hospital chain against allegations of lost profits resulting from a failed sale of multiple hospitals.

Quantified damages for a hospital for the failed implementation of a new billing and collection system by a major information systems vendor.

Assisted law firm representing one of the largest national oxygen provider chains to defend against allegations of Medicare false claims.

Assisted attorney defending a physician against allegations of overcoding and false claims, involving 1995 and 1997 E&M; documentation standards and certain CPT codes.

Assisted law firm representing a national benefits broker against allegations of the insurance brokers negligence regarding standards that are usual and customary in the health benefits industry.

Evaluated documentation to support and reasonableness of charges for over 1,900 medical services billed to a national insurance carrier.

Assisted a multi-facility mental health facility provider in reviewing prior Medicare cost reports to identify substantial underpayments by their intermediary.

Assisted law firm representing a national HMO in a dispute over the prompt payment requirements and the completeness of claims involving over $1 million in disputed claims.

Assisted a state Attorney General office to evaluate their State Auditor's results for possible use in criminal fraud charges against a home health provider.

Assisted law firm in evaluating the results achieved by a medical billing and collections service in comparison to industry averages.

Assisted law firm in quantification of proper payments for inpatient outlier claims, non-ASC procedures and late claims in a dispute between a managed care organization and a hospital.

Assisted law firm in reviewing over 50,000 pages of documents to evaluate compliance with Medicare's "incident to" requirements.

Consulting Practice

All States

More Information

Health Law Network's Services, Expert Witness

About HLN's Professional Staff, Expert Witness

About L. Lamar Blount, CPA, FHFMA, CFF - Expert Witness

Quotes from HLN Clients, Litigation Support

Health Law Network, Inc. Resources, Legal Consultant

Contact Health Law Network, Expert Witness