Editorial Board

Amanda Gilliland, RN, BSN, is the revenue integrity nurse auditor at UW Health, Madison, WI., holding similar positions there since 1985. She handles third party payer denials and is a provider representative on two state work comp committees. 

Andrew H. Hughes, MD, is a fellow in health systems management, a pulmonologist, and instructor of medicine at the Johns Hopkins University School of Medicine.

Charles Locke, MD, CHCQM-PHYADV, is a senior physician advisor of care coordination and clinical resource management at Johns Hopkins and is an assistant professor at the Johns Hopkins School of Medicine. He is also a member of the board of directors of the American College of Physician Advisors.

Angela M. Phillips, PT, is President and Chief Executive Officer of Images & Associates. A graduate of the University of Pennsylvania’s School of Allied Health Professions, she has more than 40 years of experience as a consultant, healthcare executive, hospital administrator, educator, and clinician. Ms. Phillips is one of the nation’s leading consultants assisting Inpatient Rehabilitation Facilities in operating effectively under the Medicare Prospective Payment System (PPS) and in addressing key issues related to compliance. Ms. Phillips is a member of the RACmonitor editorial board and a popular guest panelist on Monitor Mondays.

Dr. Daniel Zirkman is the chief physician advisor at CarolinaEast Medical Center in New Bern, N.C. Dr. Zirkman completed medical school at the University of Texas at San Antonio, then residency in internal medicine and fellowship in nephrology at the University of Pittsburgh. He practiced privately for 23 years.  

Dr. Zirkman began physician advising work approximately five years ago. Previously, he worked at Riverview Medical Center in Red Bank, N.J., part of the Hackensack-Meridian system, before moving to New Bern in 2017 to take on his current position at CarolinaEast Medical Center. 

Denise Nash, MD has more than 20 years of experience in the healthcare industry. In her last position, she served as senior vice president of compliance and education for MiraMed Global Services, and as such she handled all compliance and education needs, including working with external clients. Dr. Nash has worked for the Centers for Medicare & Medicaid Services (CMS) in hospital auditing and has expertise in negotiation and implementation of risk contracting for managed care plans. She has also worked with individuals as well as physician groups on utilization and Physician Quality Reporting System (PQRS) management to improve financial performance for risk-based contracts and value-based purchasing programs. Dr. Nash has past experience with episode-of-care data, hierarchical condition categories (HCCs), and patient management in the Accountable Care Organization (ACO) environment. She has also worked with both hospitals and physician practices on the legal and financial aspects of adding new services to their respective facilities. Dr. Nash is a consultant on coding/compliance audits at physician practices and hospitals, and has worked for insurance plans conducting second- and third-level appeals. Her past experience also included consulting for the Office of the Inspector General of New Hampshire in its Fraud and Abuse Division.

Duane C. Abbey, PhD, CFP, is an educator, author, and management consultant working in the healthcare field. He is president of Abbey & Abbey Consultants, Inc., which specializes in healthcare consulting and related areas. His firm is based in Ames, Iowa. Dr. Abbey earned his graduate degrees at the University of Notre Dame and Iowa State University. Dr. Abbey is a member of the RACmonitor editorial board and is a frequent guest on Monitor Mondays.

Dr. Dunbar transitioned to a physician advisor role in 2016 after 19 years in clinical practice including 14 years of night shifts in the Novant Health Charlotte Market EDs as a residency-trained, board-certified emergency physician. She enjoys the multi-faceted challenges and the collegiality of UR nursing education and staff physician education, especially in the area of documentation optimization.

Erica Remer, MD, FACEP, CCDS has a unique perspective as a practicing emergency physician for 25 years, with extensive coding, clinical documentation improvement (CDI), and ICD-10 expertise. As a physician advisor for University Hospitals Health System in Cleveland, Ohio for four years, she has trained 2,700 providers in ICD-10, closed hundreds of queries, fought numerous DRG clinical determination and medical necessity denials, and educated CDI specialists and healthcare providers with engaging, case-based presentations. She transitioned to independent consulting in July 2016. Dr. Remer is a member of the ICD10monitor editorial board and the co-host of Talk-Ten-Tuesdays. She is also on the board of directors of the American College of Physician Advisors.

Frank Cohen is the director of analytics and business Intelligence for DoctorsManagement, a Knoxville, Tenn. consulting firm. He specializes in data mining, applied statistics, practice analytics, decision support, and process improvement. He is a member of the RACmonitor editorial board and a popular contributor on Monitor Monday.

In his role as director of requester relations and receivables administration for MRO, Greg Ford serves as a liaison between MRO’s healthcare provider clients and payers requesting large volumes of medical records for purposes of post-payment audits, as well as HEDIS and risk adjustment reviews. He oversees payer audit and review projects end-to-end, from educating and supporting clients on proper billing practices and procedural obligations to streamlining processes to ensure timely delivery of medical documentation to the requesting payers. Prior to joining MRO, Ford worked as director of operations and sales at ARC Document Solutions for 15 years. He received his B.A. from Delaware Valley University.

J. Paul Spencer is a senior healthcare consultant for DoctorsManagement. Is the national correspondent for Monitor Mondays, the live Internet radio broadcast produced by RACmonitor.

Dr. Lehrman is a diplomate of the American Board of Foot and Ankle Surgery, fellow of the American Society of Podiatric Surgeons, fellow of the American College of Foot and Ankle Surgeons, and fellow of the American Academy of Podiatric Practice Management, and he is recognized as a master of the American Professional Wound Care Association. He is the Chair of the Board of Directors of the American Society of Podiatric Surgeons. He is also on the Board of Directors of the American Professional Wound Care Association. He is an expert panelist on Codingline.com and sits on the APMA Coding Committee. Dr. Lehrman has lectured nationally and internationally on practice management and other topics.

Dr. John K. Hall, MD, JD, MBA, FCLM, FRCPC is a licensed physician in several jurisdictions and is admitted to the California bar. He is also the founder of The Aegis Firm, a healthcare consulting firm providing consultative and litigation support on a wide variety of criminal and civil matters related to healthcare. He lectures frequently on black-letter health law, mediation, medical staff relations, and medical ethics, as well as patient and physician rights.

Dr. Hall hopes to help explain complex problems at the intersection of medicine and law and prepare providers to manage those problems.

Kathleen K. Borchard is a registered nurse with 36 years of experience that has spanned a multitude of nursing genres. Kathleen, a graduate of South Dakota State University, began specializing in case management in 2004, serving Milwaukee’s frail elder population. In 2010, Kathleen transitioned to acute case management at ProHealth Care Waukesha Memorial Hospital. Kathleen’s most recent accomplishment was obtaining her case management certification in 2016.

Kim Charland has over 30 years of experience in health information and revenue cycle management for hospitals and physicians. Kim has spent most of her career in product development related to healthcare consulting services, education, publishing, and software. She was responsible for the operations of a healthcare audit consulting division for many years and launched an Internet news and information platform, VBPmonitor, that focused on the transition to value-based payments. She was also the co-host of ICD10monitor’s weekly Internet news program, Talk-Ten-Tuesdays, for many years. Kim speaks nationally on topics such as quality and value-based payment initiatives, clinical documentation improvement (CDI), and documentation, coding, revenue cycle, and compliance-related issues. Kim is also the president of the New York Health Information Management Association.

Kristi Pollard is a senior coding consultant at Haugen Consulting Group. Kristi has more than 20 years of industry experience. She develops web-based and instructor-led training material and conducts training in ICD-10-CM/PCS. Kristi has an extensive background in coding education and consulting and is a national speaker on topics related to ICD-9, ICD-10, and CPT coding, as well as code-based reimbursement.

Lori O’Hara is the lead of the ADR, Appeals and Clinical Review Team for Ensign Services. She has more than 25 years of experience in the post-acute setting, ranging from hands-on clinician to interdisciplinary rehabilitation director. She currently supports her organization’s SNF line of business through claim defense and proactive development of documentation processes.

Marvin D. Mitchell, RN, BSN, MBA, is the director of case management and social work at San Gorgonio Memorial Hospital, east of Los Angeles. Building programs from the ground up has been his passion in every venue where case management is practiced. Mitchell is a member of the RACmonitor editorial board and makes frequent appearances on Monitor Mondays.

Mary Inman is a partner in the London office of Constantine Cannon, where she specializes in representing whistleblowers from the United States, Europe, and around the world under the various American whistleblower reward programs, including the False Claims Acts and the SEC, CFTC, IRS, and DOT whistleblower programs.

Max Voldman is an associate in Constantine Cannon’s Washington D.C. office.

Dr. Michael Salvatore was a pulmonary medicine/critical care physician for 35 years. Since 2012 he has been the physician advisor and medical director of the palliative care team at Beebe Healthcare in Delaware. After earning his MD at the University of Arizona, he trained in internal medicine and PULM/CCM at Duke University. Dr. Salvatore is a member of the RACmonitor editorial board.

Nancy Beckley is founder and president of Nancy Beckley & Associates LLC, providing compliance planning and outsourced compliance services to rehab providers in hospitals, rehab agencies, and private practices. Nancy is certified in healthcare compliance by the Healthcare Compliance Certification Board. She is on the board of the National Association of Rehabilitation Providers and Agencies. She previously served on the CMS Professional Expert Technical Panel for Comprehensive Outpatient Rehabilitation Facilities. Nancy is a familiar voice on Monitor Mondays, where she serves as a senior national correspondent.

Dr. Ralph Wuebker serves as Chief Medical Officer of Executive Health Resources. In this role, Dr. Wuebker provides clinical leadership within the company and works closely with hospital leaders to ensure strong utilization review and compliance programs. Additionally, Dr. Wuebker oversees Executive Health Resources’ Client Services teams, who provide onsite education for physicians, case managers, and hospital administrative personnel and help hospitals identify potential compliance vulnerabilities through ongoing internal audit.

An expert in CMS regulations, medical necessity compliance, utilization review, denials management, and program integrity efforts, Dr. Wuebker also serves as an industry thought leader and editorial advisor to the media, as well as a highly respected and distinguished industry speaker.

Sarah Hillegonds is an associate attorney at Wachler & Associates, P.C.  Ms. Hillegonds practices in all areas of healthcare law and devotes a substantial portion of her practice to representing healthcare entities in the defense of RAC, Medicare, Medicaid, and third-party payer audits.  Ms. Hillegonds also represents healthcare providers in licensing matters. 

Shannon DeConda is the founder and president of the National Alliance of Medical Auditing Specialists (NAMAS) as well as the president of coding and billing services and a partner at DoctorsManagement, LLC. Ms. DeConda has more than 16 years of experience as a multi-specialty auditor and coder. She has helped coders, medical chart auditors, and medical practices optimize business processes and maximize reimbursement by identifying lost revenue. Since founding NAMAS in 2007, Ms. DeConda has developed the NAMAS CPMA® Certification Training, written the NAMAS CPMA® Study Guide, and launched a wide variety of educational products and web-based educational tools to help coders, auditors, and medical providers improve their efficiencies. Shannon is a member of the RACmonitor editorial board and is a popular guest on Monitor Mondays.

Steven Meyerson, MD, CHCQM-PHYADV, is the founder of Steven Meyerson Consulting. Dr. Meyerson is a nationally recognized expert and consultant in the physician advisor role, case management, and hospital Medicare compliance. He is board certified in internal medicine and geriatrics and serves on the board of the American College of Physician Advisors (ACPA). He edits and writes for the ACPA online blog.