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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. Jeff was named as a SuperLawyer by Washington Law & Politics in 2008 and 2009.
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 holds a BA, MA and MBA in Healthcare Administration. His undergraduate studies were at the University of Washington, and his graduate work was at City University of Seattle and the University of California at Berkeley. His academic honors include graduating cum laude from the University of Washington and being elected to the Phi Beta Kappa Honor Society. He is a Fellow of the Healthcare Financial Managers Association and a member of the American College of Healthcare Executives.
Terri Brame, Director of Reimbursement and Compliance holds multiple coding and compliance credentials, including Certified in Healthcare Compliance (CHC), Certified Professional Coding Instructor (CPC-I), specialty certification in general surgery coding (CGSC), and general coding certifications for both physician and outpatient hospital (CPC, CPC-H). She has worked in both academic and private physician practices in compliance, coding, and revenue cycle management roles.
Terri's responsibilities at the firm encompass a variety of reimbursement and compliance activities, such as:
- Identifying missed revenue opportunities for hospitals and physicians through the review of historical billing data;
- Assisting medical practices and hospitals in securing payment for wrongfully-denied claims;
- Developing compliance programs for hospitals and physicians who have been identified by payers for repayment demands;
- Assisting hospitals and physicians in reducing unnecessary billing exposure due to insufficient documentation;
- Training physicians how to document effectively for evaluation and management services; and
- Reviewing payer audits for clients in order to support negotiations and settlements.
Highlights of Terri's career include:
- Currently writing the first coding textbook devoted to Evaluation & Management coding principles and practice for a major nursing and affiliated health textbook publisher;
- Coding or auditing over 15,000 E&M notes, providing for depth of experience.
- Speaking nationally as a recognized authority on surgical and primary care physician coding and compliance;
- Developing and implementing the first billing compliance program for a multi-specialty physician practice, including writing policies and procedures, designing an audit plan, and developing the initial HIPAA privacy program;
- Identifying a missed billing opportunity for a transplant practice that resulted in increased recurring annual revenue of $150,000;
- Designing and implementing the multi-year coding and billing compliance training program for a 100 provider practice;
- Training residents in preparation of launching independent practices;
- Guiding rural health care physicians and non-physician practitioners in sound coding and billing practices;
- Working to bridge communication styles and improve understanding between hospitals and provider practices;
- Serving on a health system committee to improve medical center operating room forecasts based on costs and utilization;
- Realigning fee schedules and managing denials for proper revenue recovery; and
- Providing clinical revenue analysis in support of comprehensive budgeting and forecasting models.
Terri holds a BS and MBA in healthcare administration from Bellevue University, Bellevue, Nebraska and is a member of the Health Care Compliance Association (HCCA) and the American Academy of Professional Coders (AAPC). Terri has worked at the University of Washington School of Medicine and for major physician practices in Omaha and Lincoln Nebraska.
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.
Kristin Peterson is an attorney at Coopersmith Health Law Group. Before joining our team, Kristin was Director of Legal and Clinical Policy at the Washington State Hospital Association where she advised hospitals and providers statewide. Her knowledge of health care laws and regulation also stem from her experience working for members of the Washington State Legislature, a U.S. senator, and a legal internship with the Association of Washington Public Hospital Districts. During law school, she externed for Washington State Supreme Court Justice Tom Chambers and U.S. Magistrate Monica J. Benton. After law school she clerked for the Honorable Gerald L. Knight.
Value to Clients
Kristin's background and experience enable her to:
- Understand and communicate to physicians and hospitals the requirements of complex laws and regulations
- Build relationships with state and regulatory agencies to resolve issues affecting hospital operations and licensing
- Advise physicians and hospitals on statutory and regulatory mandates
- Help hospitals incorporate new laws and regulations into their policies and procedures
- Act as a liaison between regulators and hospitals seeking agency guidance on compliance
Kristin has favorably negotiated physician agreements, developed strategic responses to payer audits, and helped physicians understand their regulatory and legal obligations as both a provider and a business.
Professional Organizations
Kristin serves with physicians on the advisory committees of two state-wide physician quality improvement initiatives: COAP (the Clinical Outcomes Assessment Program) and SCOAP (the Surgical Care and Outcomes Assessment Program.
Presentations
Recent presentations Kristin has delivered on health care law and regulation:
“Hospital Volunteers: Laws, Regulations, and an Approach to Risk Management,” delivered to the Washington State Society of Directors of Volunteer Services in HealthCare”, May 2009
“Federal Health Care Update,” delivered at the plenary session at the Washington State Hospital Association Rural Conference, May 2008
“Washington State Department of Health Licensing Update,” delivered to the Washington State Society of Healthcare Attorneys, April 2007
Community Involvement
Volunteer, King County Bar Association, Neighborhood Legal Clinics, 2002 – present
Board Member, King County Washington Women Lawyers, 2005-2009
Board Member and Secretary, Municipal League of King County, 2006-2009
Kristin is a member of the Washington State Society of Healthcare Attorneys and the American Health Lawyers Association.
Education
Kristin is a graduate of The Evergreen State College and the University of Washington School of Law.
Molly Miller is the Director of Provider Contracting. Her areas of expertise and enthusiasm are helping providers to build relationships with payers, engage carriers in contract negotiations, conduct contract language review, provide fee schedule analysis and development, resolve claim disputes and assist providers with credentialing.
Molly joins Coopersmith Health Law Group from Regence BlueShield, where she was a Provider Network Executive responsible for provider and hospital contracting. She negotiated contracts with a broad range of providers that included some of the largest hospital systems in the state, community hospitals, multispecialty clinics, single specialty clinics, and ambulatory surgery centers.
She worked with many different medical specialties such as anesthesiology, neurosurgery, pulmonology, emergency medicine, gastroenterology, infectious disease, oncology, orthopedics, radiology, physical therapy and urology. She is well-versed in contracting strategy, methodology and language.
Molly has additional contracting experience with United Healthcare as a Senior Network Account Manager, where she was responsible for all aspects of hospital contracts across the state. As part of a large scale merger during her tenure there, she had the opportunity to recruit and contract with physicians in Northern California.
As a Provider Relationship Liaison with Aetna she traveled across the state for provider education and physician recruitment. Her service area at Aetna included most of Eastern Washington as well as King, Pierce, Snohomish and Thurston Counties. Additionally, she worked on complex claims issues and assisted providers with coding and procedural issues. Early in her career Molly spent four years as a billing specialist in a small clinic, as well as two years as a claims analyst in an anesthesia billing agency in Spokane.
This comprehensive perspective allows Molly to assist all providers, from large hospitals to solo practitioners, with their contracting needs.
Molly firmly believes in building and maintaining working relationships between providers and payers for the benefit of patients. Her favorite part of the health care field is that it is constantly changing and challenging. She has a special interest in creating office efficiencies, enabling any practice to make the most of the reimbursement they receive.
Molly holds a BA in Business Administration from Eastern Washington University, and is completing her MBA at the University of Washington.
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