HLN offers 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.
HLN provides experts in: medical billing, reasonableness of charges, reasonable value of medical services, Medicare & Medicaid reimbursement and compliance, clinical documentation, medical record coding, economic damages, insurance disputes, lost profits and false claims. HLN's founder co-authored two editions of the AMA's best selling Mastering the Reimbursement Process book.
Revised and updated with more than 200 pages of new information, this outstanding book guides users through the reimbursement process from start to finish. Perfect for trainers, students, and veteran reimbursement professionals alike, this Third Edition offers concise, informative, and easy-to-understand overviews of insurance basics, types of insurance and payers, coding systems, insurance processing, and review and appeals.
Health Care Coding Economics and Regulatory Consultant Michael Arrigo
Michael Arrigo is the Managing Partner, Healthcare Practice for No World Borders, and is a testifying expert witness. He works with health systems, health IT companies, and health plans. Recent retentions by the U.S. Department of Justice (DOJ) include drug pricing, patent infringement, medical coding, and billing and Qui Tam False Claims Act and fraud case specialties.
Mr. Arrigo has in-depth experience in HIPAA mandates, the HITECH Act and Patient Protection and Affordable Care Act (PPACA), and is a published author and regular speaker. He consults to clients including Health IT investors, Health IT companies, and health plans and hospital systems in matters regarding HIPAA Privacy Rule, HIPAA Security Rule, HIPAA Breaches, Revenue Cycle Management.
Meaningful Use of Electronic Health Care Records
Quality Measures for Medicare Advantage Hospital Value-Based Purchasing
Medicare Advantage HEDIS 5-Star Ratings for Health Plans Mr. Arrigo was recently quoted in the Wall Street Journal Venture Capital Dispatch regarding medical coding standards and Wall Street Journal Health Blog regarding venture-backed information-technology companies that serve hospitals and health insurers.
Medicare Local Coverage Determinations (LCDs) and National Coverage Determinations (NCDs)
Clinical documentation improvement (CDI) initiatives are underway in healthcare organizations across the country, with the aims of improving care and reducing costs. Are they working? At least one such initiative, at Baptist Health South Florida, is providing solid return on investment.