Medical Billing and Coding 101

In order to craft an effective legal strategy to assist clients in reaching their business goals, Sean Timmons draws on a wealth of practical experience and solid understanding of the health care industry, coupled with a firm grasp of substantive law in this highly regulated environment.

Sean advises clients on complex regulatory issues including compliance with federal and state fraud and abuse laws and regulations. He has defended clients in Medicare and Medicaid administrative proceedings and has assisted clients in responding to and negotiating resolutions of government investigations into Medicare and Medicaid billing practices. He has commonly assisted clients on acquisitions and joint ventures involving healthcare entities, including advising clients on the application of the federal health care program’s anti-kickback statute and federal physician self-referral (or “Stark”) statute.

Patrice Morin-Spatz is a medical coding and reimbursement subject matter expert supporting clientele throughout the United States with almost 30 years of experience in her field. She is a former editor of the American Medical Association’s (AMA) Current Procedural Terminology (CPT?) book, and a published author who maintains 49 copyrights for her books on medical coding. Her expertise has been utilized by the DOJ, DoD, attorneys, insurance companies, clinics, medical associations and health care organizations worldwide. Whether testifying in medical fraud and abuse, patent infringement, or medical malpractice cases, or assisting in the recouping of monies for physicians, providing seminars, audits, in-house consultations, superbill reviews or fee slip analysis for clients, her emphasis and expertise stress the proper and accurate coding of medical claims using the CPT book. Ms. Morin-Spatz has dedicated her career to assisting individuals and organizations in the legal, medical, academic and governmental industries.

As a lecturer, Ms. Morin-Spatz has educated and trained more than 35,000 individuals worldwide through seminars and audits. She has provided depositions, testified at trial, and provided multiple opinions in cases that then settled out of court. She is comfortable in front of a jury and uses an instructive type approach so that the members can draw the correct conclusions about the case. Her commitment to excellence leads her to continue developing additional products and services. She was a winner of the 2011 prestigious McGuffey Award through the Text and Academic Authors Association for creating cp“Teach?,” the very first, longest standing and annually updated “how-to” text on CPT coding in the industry and was also the winner of the esteemed 2012 Ben Franklin Award in Science by the Independent Book Publishers Association for a title she co-authored with John Brady, M.D., Ph.D.. Body Works. Patrice was a 2013 appointee to the prestigious TAA Council of Fellows, an honor given to only a handful of individuals worldwide for the teaching, authoring and consulting contributions she made on such a large scale. Her medical insurance coding book line has been used by more than 900 schools and universities.

She is a skilled and accomplished speaker, and fluent in both English and Spanish. She maintains both her CPC, CPMA, CHCI and CMSCS certifications through the AAPC and PAHCS. Her knowledge of medical practices and the medical field in general has been invaluable in helping litigators understand the facts of the case and in assisting them at honing in on both the strengths and weaknesses of their arguments.