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Staff
The Coopersmith Health Law Group includes former regulators, the former head of provider contracting for Regence BlueShield, a physician, an investigator and a certified coding specialist who are dedicated to helping our clients build and sustain profitable, satisfying medical practices.
Jeff Coopersmith is president of Coopersmith Health Law Group and the former Chief Counsel and Director of Enforcement at the Washington State Office of the Insurance Commissioner.
Jeff works closely with clients and members of the firm to craft a cost-effective strategy that meets the specific needs of each client.
He has had the privilege of dealing first-hand with leaders in government, the insurance industry, and the medical profession. The trust and respect that he has earned has produced a strong record of results for clients that includes both resolving immediate disputes and protecting their long-term interests.
Jeff and the firm take great pride in improving clients' revenue recovery and compliance so that they can focus on what they do best: patient care.
As Chief Counsel for the Office of the Insurance Commissioner, Jeff created the first systematic prosecution of the insurance industry in state history. He won record fines and refunds, and forced insurers to change their business practices to benefit physicians and patients.
Among the many landmark settlements Coopersmith negotiated are:
- The first agreement in the nation to compel insurers to pay emergency-room claims on a standard favorable to patients and doctors,
- The first agreement in the state to ensure that women have direct access to women's health providers, and
- A multitude of agreements to reverse insurers' wrongful denials of treatment.
Jeff speaks widely about how medical practices and hospitals can improve profitability, reduce the many risks associated with non-compliance, and develop positive working relationships with insurance companies and regulators. He has spoken to many Washington State Medical Association audiences, as well as the National Association of Insurance Commissioners, the American College of Emergency-Room Physicians (Washington chapter), the Washington State Bar Association, and county and specialist societies across the state.
In Congress, Jeff was in charge of health-care issues for a Member of Congress during a major overhaul of the Medicare system. He also has extensive experience in trying cases through his service as a King County deputy prosecutor and work for a Federal judge.
Coopersmith is a graduate of Princeton University and the University of Wisconsin Law School.
Dwight Johnson is the Director of Provider Contracting at Coopersmith Health Law Group. Dwight has an extensive background in provider contracting. His experience includes six years as the Assistant Director of Provider Contracting at Regence BlueShield, where he was responsible for all provider contracting, and five years with Premera BlueCross where he was responsible for all hospital and ancillary contracting in Washington and Alaska.
At the firm, Dwight applies his broad knowledge of healthcare contracting in his work, which includes provider-payer negotiations, contract review, fee schedule analysis and development, claims process examination, discussions with brokers and work with regulatory agencies. The goal of his efforts is to create resolution out of conflict, allowing providers and payers to come together in delivering care to the mutual clients they serve.
Following are highlights of Dwight's career:
- His accomplishments at Regence included a complete reweighting of the in-house APDRG grouper, directing the Regence hospital recontracting initiative, writing and successful submission of provider contracts to the Washington State Office of the Insurance Commissioner and assisting the sales and marketing teams with the generation of new business. He was also a key member of the highest level of the internal appeals and provider regulation processes at Regence.
- At Premera, he played a key role in the development and implementation of the APG methodology employed by the company and created a spot-pricing program, which facilitated a smoother transition of patients in lower acuity stages. He also was responsible for all hospital and ancillary contracting in Washington and Alaska.
In addition to his extensive experience on the payer side, Mr. Johnson also worked for many years on the provider side.
- He was the Director of Financial Services for Valley General Hospital. While there, he completed a major overhaul of the hospital business office operations, lowering A/R outstanding by 20 days and increasing cash flow to the hospital on a million dollar basis.
- Prior to his time at Valley General, he worked for three years at Virginia Mason Clinic where he played a lead role in patient account services and one year at Swedish Hospital where he streamlined operations in the hospital business office.
Dwight has an MBA in Healthcare Administration from City University of Seattle, an MA in Political Science from the University of California at Berkeley, and graduated cum laude with a BA in Political Science from the University of Washington. He is a Fellow of the Healthcare Financial Managers Association and a member of the American College of Healthcare Executives and Phi Beta Kappa Honor Society.
Emily Davis is the managing attorney at Coopersmith Health Law Group. Prior to joining the firm, Emily was Vice President and General Counsel of Seattle-based Northern Life Insurance Company and served as legal counsel to insurance companies for over 25 years. In those positions, she worked closely with business units to identify legal problems and find solutions that supported their goals.
In addition to her legal expertise, Emily has significant business experience in the private sector, including:
- Working with federal and state agencies to obtain approvals for products and business practices that advanced the company's interests;
- Negotiating and drafting a wide variety of business contracts with individuals, insurers and other corporations;
- Translating complex laws into understandable business practices and developing procedure manuals and training to implement them;
- Serving in leadership positions on two industry boards (Washington Life and Disability Insurance Guaranty Association and Washington Insurance Council);
- Leading several corporate functions, including Human Resources, Law, and Corporate Communications; and
- Supervising litigation counsel.
Emily is a graduate of the University of Connecticut and the University of Connecticut School of Law. She is licensed to practice law in Washington, California, and Connecticut.
Susan Pellicano is a Registered Health Information Administrator (RHIA) and a Clinical Coding Specialist, Physician Based (CCS-P) with more than twenty-five years in the health care industry. She has held a variety of positions in both academic and community hospital settings, in health information management and hospital finance.
Susan's responsibilities at the firm include:
- Identifying missed revenue opportunities for physicians through the review of historical billing data,
- Assisting medical practices and hospitals in securing payment for wrongfully-denied claims,
- Developing compliance programs for physicians who have been identified by payers for repayment demands,
- Assisting physicians in eliminating unnecessary billing exposure due to insufficient documentation,
- Training physicians how to document effectively for evaluation and management services,
- Reviewing payer audits for clients in order to support negotiations and settlements, and
- Providing quarterly coding reports for our clients to the Department of Health, Washington State Labor and Industry, and commercial payers that are mandated in settlement negotiations.
She has worked at Swedish Medical Center, Harborview Medical Center, University of Washington Medical Center, and Evergreen Healthcare in Kirkland, Washington.
Highlights of Susan's career include:
- Recovering over one million dollars on denied public and commercial hospital accounts. Payment was secured for 350 aged claims that were considered futile to recover;
- Optimizing hospital reimbursement by identifying complications or co-morbid conditions for Diagnosis Related Groups (DRGs) and Ambulatory Patient Classification (APC) prospective payment systems;
- Establishing and maintaining professional fees for a solid organ transplant program at a major Seattle hospital;
- Creating a system to ensure that all fees for unplanned and unscheduled surgeries were captured in a busy clinic setting; and
- Updating hospital charge masters to reflect accurate billing practices for professional and facility fees.
- Analyzing physician practice patterns by charges, cost centers, specialties, length of stay, etc. for a major hospital and proving these reports for budgeting and special studies.
As a Corporate Compliance Auditor, Susan assisted in the development of a process that assured compliance with public and commercial payer obligations. She has seven years experience as the Director of Health of Information Services in two small community hospitals where she was responsible for daily operations, which included overseeing Transcription and Utilization Review.
Susan is a graduate of the University of Kansas in Medical Record Administration and a member of the Healthcare Financial Management Association (HFMA), American Health Information Management Association (AHIMA), and the Health Care Compliance Association (HCCA).
Dr. Lisa Erlanger is the Medical Director of Coopersmith Health Law Group, where she evaluates the medical aspects of cases when the need arises.
Dr. Erlanger is a board-certified family medicine specialist. She spent the last ten years teaching at the Providence Family Medicine Residency, part of the Swedish Medical Center. During that time, her clinical practice was located at Swedish Medical Center where she provided everything from obstetric to geriatric care. Dr. Erlanger is now a staff physician at the University of Washington.
She is a graduate of the Washington University School of Medicine in St. Louis and the Providence Family Medicine Residency in Seattle.
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