Speaker: Robert B. Burleigh, CHBME

President, Brandywine Healthcare Services

Bob has over forty-three years of healthcare financial management experience. His career has included eight years of hands-on and executive level hospital patient accounting for a 500 bed community hospital and an international chain of for-profit hospitals, eight years with Shared Medical Systems (SMS) [now Cerner] in both the Hospital and Physicians Services Division related to systems sales and delivery, project management, billing service management and consulting, and twenty-eight years as founder and President of Brandywine Healthcare Services.

Bob has conducted hundreds of engagements in medical practices, billing companies and hospitals in forty-eight states, including: practice performance reviews; assessment of billing operations; interim management and turn-around management of billing operations; compliance program development and audits; vendor performance audits, selections, and contract negotiations for billing services and coding services; coding and fee schedule reviews; billing and EDI software systems evaluations, selections, audits and contract negotiations; and litigation support of suits involving hospitals, physicians and billing service bureaus, including expert testimony and damage calculation.

Clients have included: medical schools; medical practices in virtually every specialty and sub-specialty; municipal, not-for-profit and for-profit hospitals; government agencies; law firms; public accounting firms; health insurance companies; healthcare trade associations and healthcare billing companies.

In 2003 and early 2004, Mr. Burleigh served as President and CEO of Alpha Thought Global, Inc., (ATG) one of the largest medical billing companies in the U.S. With offices in six states and New Delhi, India, ATG specialized in hospital-based medical practice billing, with clients in over twenty states. In late February 2004, he resumed the consulting practice he founded in 1988, Brandywine Healthcare Service. From 2009 to 2011, Bob served as Program Director for the RAC (Recovery Audit Contractor) Validation Contractor – Provider Resources, Inc., overseeing the initiation and operation of RAC oversight of CMS’ four RAC Contractors, including review and approval/denial of RAC audit proposals, assessment of RAC audit performance, and RAC policy development.

He has testified before Congress and NCVHS regarding patient privacy and the healthcare billing industry, as well as advising HCFA/CMS regarding billing company and physician compliance, the 4010 and 5010 transaction code sets, ICD-10 CM, provider enrollment, certificates of medical necessity (CMN), and physician documentation guidelines. He is a nationally recognized authority on billing services, professional service coding and fees, regulatory compliance, medical practice management, physician contracting, the management of hospital based medical practices, hospital departments and hospital patient accounting. Bob has been advising CMS on policy development and changes for over 15 years.

Bob is a frequent lecturer and author for numerous organizations including the Healthcare Billing and Management Association, Medical Group Management Association, Health Care Compliance Association, Healthcare Financial Management Association, American Health Lawyers Association, American Hospital Association, American Association of Healthcare Administrative Management, American College of Emergency Physicians, Radiology Business Management Association, American Pathology Foundation, American Collectors Association, and many others. Bob’s authorship includes contributions to books on hospital and physician reimbursement, CPT-4 coding, contracts and risk management, emergency department management, feasibility studies and billing, for publishers such as the CCH, AHA, Aspen, Mosby’s, ACEP, as well as numerous articles published by the Journal of Health Care Compliance, Part B News, Part B Insider (member of the Editorial Board), Medicare Compliance Alert, Report on Medicare Compliance, BILLING, Health Care Biller, Journal of Healthcare Financial Management, The Journal of Patient Accounting, ED Management and ED Physician News, Physician Payment Update, and many others.