Amy has over 20 years of healthcare experience and specializes in regulatory compliance for coding and billing with an emphasis in documentation, coding and billing reviews; due diligence and risk assessment reviews; internal investigations, and litigation support services. Amy has extensive experience working with publicly traded healthcare companies, large hospital systems, law firms and physician group practices. Amy’s experience ranges from handling routine compliance issues to provider defense of government false claims and fraudulent coding and billing cases. Amy is certified in healthcare compliance and is also a certified coder for both physician and hospital coding, and an approved coding instructor for the American Academy of Professional Coders. She has taken many leadership roles in the industry, including currently serving as an Auditing and Monitoring Tools Editorial Board Member for the Healthcare Compliance Association and is also a former Regional Governor and Examination Committee Chair American College of Medical Coding Specialists. Amy has published articles featured in Compliance Today and Health Lawyers Weekly and is a co-author of the American Health Lawyers Compliance Manual. She has also been selected as a speaker for groups including the American Health Lawyers Association, American Academy of Professional Coders, Healthcare Compliance Association, Georgia Hospital Association, Idaho Medical Group Management Association and the Idaho Association of Home Care.
Ken has over 30 years of experience in public practice including consulting and litigation support services for health care providers. He is a licensed CPA in Idaho and Washington. Ken’s healthcare consulting experience includes provider compliance and litigation matters including due diligence, internal investigations, self-reporting, and forensic services. Ken has testified, been deposed, or consulted on cases in both Federal and state courts. He has also served in interim compliance positions while a permanent replacement was recruited. Ken is a prior contributing author of the American Health Lawyers Association Healthcare Compliance Legal Issues Manual. He also is a former board member of the Idaho Food Bank and former corporate contributions chair for the Idaho Easter Seals.
Sarah has over 20 years of billing and coding experience, which includes serving as a Coding Manager for a large third-party medical billing company, as well as, providing expert consulting services on matters involving compliant coding and billing. She has performed documentation, coding, and billing audits. She has also overseen coding and billing operations for a variety of provider services including: evaluation and management, pain management, radiology, radiation and medical oncology, emergency department, anesthesiology, and pathology. She routinely provides customized education and training regarding proper documentation and coding to both coders and providers. She has lectured on compliant documentation, coding, and billing to national organizations including the American Academy of Professional Coders, the Healthcare Compliance Association, and the Idaho Health Care Association. She has also published articles in the American Health Lawyers Association, Health Lawyers Weekly.
Richard is a professional statistician with 15 years of experience as a statistical consultant. He holds statistical degrees from Northwestern University and University of Idaho (MS Statistics); and current research appointments as Affiliate Faculty at the College of Pharmacy at Idaho State University and Statistician at Boise Veterans Affairs Medical Center. Richard’s experience applying statistical methods is broad, including: medical research, environmental research, agricultural experiments, statistical process control of business analytics, sampling design and extrapolation in large billing disputes. In all of this work, his primary objectives are to identify appropriate statistical methods, assess data adequacy, handle statistical aspects of missing data, provide rigorous and defensible data analysis, and assist with interpretation and reporting of results. Richard has also developed and taught both graduate school statistics and continuing education courses in applied statistical methods, and recently fulfilled a five-year term as President of the American Statistical Association, Snake River Chapter.
Gregory Palega has over 17 years of health-law experience as both a licensed physician and attorney. He is a recognized expert in Medicare compliance and related medical necessity issues. Greg’s experience ranges from federal court expert witness testimony to Office of Medicare Hearings and Appeals testimony, as well as US department of Health and Human Services CIA-IRO audits. In addition, Greg practices hospital internal medicine full time.
After receiving a medical degree with highest honors at Cornell University Medical School in 1994 Greg completed an Internal Medicine residency at Duke University Medical Center and began private practice in internal medicine. He has been practicing as a board-certified Internal Medicine specialist since 1997, with ongoing inpatient hospital and outpatient experience. In 2006 Greg received his license to practice Law from the California Bar Association and since then has focused on healthcare regulations and compliance. He has testified in several state and federal venues concerning medical necessity, billing, and documentation disputes as well as provided expert opinions during several U.S Department of Justice investigations into Medicare fraud.
In addition to litigation matters, Greg has provided physician and case-manager education to several healthcare institutions over the last 14 years. These healthcare companies range from single hospitals to large, publicly traded national corporations. The focus has been on Medicare medical necessity, E&M coding, and documentation requirements. Likewise, Greg has lectured at numerous events for national organizations across the United States on these same issues. Further, Greg has served and continues to serve as the lead physician auditor for several U.S Department of Health and Human Services (HHS) corporate integrity agreements (CIAs). In this roll, Greg functions as the physician expert authorized by HHS to determine if the audited records meet Medicare’s medical necessity and documentation requirements for submitting a claim for payment.
Dr. Farrell is a practicing, board certified urologist with over a decade of clinical experience. Prior to joining private practice, he served in the U.S. Army as a urologist. Dr. Farrell has expertise in clinical documentation, medical coding, and medical necessity. He is a physician champion and proven leader. His physician training programs have directly resulted in improved accuracy and timeliness of clinical documentation, claim submission, increased productivity, and revenue. Dr. Farrell works collaboratively with HBE Advisors to develop successful physician and clinical staff education programs.
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