Billing and Consulting
President & CEO


Professional Profile - Summary

Total Medicare experience with fiscal Intermediaries and providers spans for more than 25 years. Started with Medicare in 1987 as an Auditor with the Fiscal Intermediary for Puerto Rico and the U.S. Virgin Islands.

Moved to Jacksonville Florida in 1993, and was employed as an Auditor in the Provider Audit and Reimbursement Department of Blue Cross Blue Shield of Florida (BCBSF). Worked until November 1996 a Senior Auditor in charge of the audits for all Comprehensive Outpatient Rehabilitation Facilities (CORF), Outpatient Rehabilitation Facilities (ORF) and Community Mental Health Centers (CMHC), within the State of Florida. These audits represented over $125 million/year at risk to the Medicare Program.

Increased the audit productivity for these facilities through developing the first automated process for the Fiscal Intermediary to settle the HCFA form 2088-79 cost report. In addition, developed audit programs, used by BCBSF and government agencies to audit the provider facilities, involved in planning and coordinating special audit initiatives with CMS (f/k/a HCFA) and the Office of Inspector General (OIG), and planning & coordinating seminars for the outpatient provider community in Florida.

Lead researcher for several audit & reimbursement issues such as: Offsite Billing, Satellite/Extension Offices, Related Party Transactions, Bad Debts, Owner’s Compensation, Physician’s Compensation and others. While working for BCBSF, saved the Medicare program millions of dollars through efficient audits and at the same time maintained an excellent rapport with the provider community.

Assisting providers since late 1996 as an independent consultant. Have a Bachelor’s Degree in science with major in accounting and have the advantage of having such specialized knowledge in the Medicare field, from both the fiscal Intermediary’s and the provider’s points of view. Fully bilingual (English and Spanish) and member of several healthcare associations.