Pharmacology Medical File Review Consultants

Internal Medicine - Experienced senior physician executive in the health insurance industry. Yale-educated, NIH-trained. Certified as Health Insurance Executive. National insurance companies worked for include Blue Cross & Blue Shield, Wellpoint, Anthem, and Cigna. Conducted over 2,000 committee and in-person patient grievance & appeal reviews. Conducted over 5,000 utilization/medical necessity reviews. Conducted over 500 physician appeal hearings; and 100 physician coding audits. Served as an examiner for the Malcolm Baldrige National Quality Award and the National Committee for Quality Assurance.

Anesthesiology - I am an MD, Board Certified in Anesthesiology. I have extensive experience in Pharmacology, Physiology and Anatomy. I have been a practicing Anesthesiologist for 10 yrs. I would love to help in any way possible.

Emergency Medicine, Sports Medicine - Current Specialties: Primary Care Sports Medicine & Emergency Medicine. (Maintain Pharmacy License as well.) Experience: former adjunct clinical faculty appointments at 2 medical schools; numerous speaking/lecturing activities; previously on Speakers Bureau for two Pharmaceutical Companies. After taking the SEAK course "How to Start, Build, and Run a Successful Disability and File Review Practice," I look to make file review an integral part of my professional activities. Particular Interests: Medical Necessity/Utilization Reviews, Pre-Authorizations, Chart Reviews, Disability Reviews.

Pediatrics, Toxicology - Registered Pharmacist (Arizona Board of Pharmacy), Hospital Pharmacy Residency (Sunnybrook Medical Center/University of Toronto, Toronto ON); Consulting Medical Toxicologist for Arizona Poison and Drug Information Center (Tucson AZ), Affiliated Medical Toxicologist for Banner University Medical Center (Phoenix AZ); Faculty Appointments: University of Arizona College of Medicine Phoenix, University of Arizona College of Pharmacy Tucson, Mayo Clinic Alix School of Medicine, Creighton University School of Medicine, A.T. Still University School of Osteopathic Medicine; ACLS, PALS, ATLS, AHLS

Internal Medicine, Nephrology - I have been in nephrology private practice since 2013. I am a medical director with Fresenius medical care (since 2015).

Emergency Medicine, Pediatric Emergency Medicine - Assistant Professor Emergency Medicine and Child Health University of Arizona and Creighton University College of Medicine

Urology/Urological Surgery - Obtained Doctorate of Pharmacy and then went on to complete Medical school and completed residency training in Urology. I have authored Cochrane systematic reviews, research papers, and presented at urology conferences. I remain very active clinically, doing both surgeries and seeing large volume of clinic patients. I also do E-consults through an electronic platform where I provide expert opinion to inquiries submitted by primary care physicians. I am highly motivated to do medical file review consulting and believe I have good clinical background.

30+ years experience as personal injury chiropractor and pharmacist. Well-reasoned in legal testimony. 6 years experience as family nurse practitioner. 10 years extensive experience in claims review. Prompt, efficient turn-around of reviews. References and/or CV available. Licensed in multiple states. Call 361-392-1100 or [email protected]