Defendant's Designation of Experts Witnesses - No Fee Documents Index # 29 August 11, 2022 (2024)

 
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 CAUSE NO. 276908 UBELESTEZ LERMA IN THE DISTRICT COURT OF FORT BEND COUNTY, TEXAS TERRANCE HLAVINKA CATTLE COMPANY and RAYMOND LEAL, JR. JUDICIAL DISTRICT DEFENDANT DESIGNATION OF EXPERT WITNESSESTO THE HONORABLE JUDGE OF SAID COURT: COME NOW, TERRANCE HLAVINKA CATTLE COMPANY and RAYMONDLEAL, JR., (“Defendant”) and files this Designation of Expert Witnesses, which shall serve tosupplement any and all previous discovery responses to reflect that the following persons may becalled to give expert testimony at the trial of this case: DEFENDANT’S RETAINED EXPERTS R. Alexander Mohr, MD MedEx Reviews 3536 Hwy 6 South, Suite #271 Sugar Land, TX Dr. is a board certified orthopedic surgeon and an expert in the area of orthopedic medicine. Dr. is expected to testify concerning Plaintiff’s alleged medical condition, history, treatment, prognosis, and alleged damages, including reasonableness and necessity of the claimed past and future medical treatment and related expenses. Dr. ’s opinions are based upon his education, experience, training, research, and expertise along with his review of documents provided to him, including Plaintiff’s medical records. Dr. Mohr also testify as to his qualifications. Dr. may also provide rebuttal testimony regarding any testimony offered by the Plaintiff or others on matters within the scope of his expertise. Dr. Mohr’s opinions are based on his review Plaintiff’s pleadings, discovery responses, and medical records in forming his opinion. Dr. will be made available for deposition at a mutually convenient date and time, upon specific written request, reasonably promptly after the deposition of Plaintiff’s testifying expert. Dr. Mohr’s curriculum vitae is attached. Defendants reserve the right to supplement and/or amend this designation as additional information becomes available. A list of items provided to Dr. Mohr includes those records identified in his report including: 1. Plaintiff’s Petition, 2. Docket Control Order, 3. Plaintiff’s discovery responses, 4. Medical records and bills from Oakbend Medical Center, 5. Medical records and bills from Thomas Jones, MD, 6. Medical records and bills from Ace Pain Management, 7. Medical records and bills from Dr. Amitabh Shukla, 8. Medical records and bills from Dr. William Colgan/Chiropractic Arts Center, 9. Medical records and bills from Fort Bend Imaging, and 10. Medical records from Fort Bend County EMS.2. Pamela Joslin Texas Medical Legal Consultants, LLC 13409 NW Military Highway, Suite 200 Shavano Park, TX 78231 Ms. Joslin is an expert in the area of medical billing and cost. Ms. Joslin is expected to testify concerning the reasonableness of Plaintiff’s medical expenses. Ms. Joslin’s opinions are based upon her education, experience, training, research, and expertise along with her review of documents provided to her, including Plaintiff’s billing records. Ms. Joslin will also testify as to her qualifications. Ms. Joslin may also provide rebuttal testimony regarding any testimony offered by the Plaintiff or others on matters within the scope of her expertise. Ms. Joslin’s opinions are based on her review Plaintiff’s pleadings, discovery responses, and medical records in forming her opinion. Ms. Joslin will be made available for deposition at a mutually convenient date and time, upon specific written request, reasonably promptly after the deposition of Plaintiff’s testifying expert. Ms. Joslin’s curriculum vitae is attached. Defendant reserves the right to supplement and/or amend this designation as additional information becomes available. A list of all items that will be provided to Ms. Joslin includes the following: 1. Bills and records from Oakbend Hospital; and 2. Bills and records from Dr. William Colgan. II. NON-RETAINED EXPERTS The physicians named below are non-retained treating physicians of Plaintiff, in theregular course of business and may testify concerning the health of Plaintiff, as well as injuries,treatment and prognoses. In particular, Plaintiff’s doctors are expected to testify about Plaintiff’smedical conditions and any disorders or illnesses present at the time of the accident, the onset ofany disorders or illnesses experienced by Plaintiff at the time of the accident and treatmentreceived by Plaintiff for any disorders or illnesses they were experiencing at the time of theaccident. These opinions are based on the physicians' care and treatment of Plaintiff and review ofmedical records. Said physicians are not retained by, employed by, or otherwise subject to thecontrol of Defendant. Defendant does not stipulate to the qualifications of the persons or entitieslisted below or to their methodologies for rendering any of their opinions. Please see the medicalrecords of said healthcare providers as well as all other medical records and reports of Plaintifffor further information relative to the substance of such physicians' mental impressions andopinions, as well as a brief summary of the basis for them. The custodians listed below will testify in accordance with his/her Deposition on WrittenQuestions and will be called to testify that the records in question are business records and meetthe "business records" exception to the hearsay rule and, if applicable, the amount of medicalexpenses of Plaintiff which have been written off or adjusted pursuant to an agreement with theprovider paying Plaintiff's medical expenses and/or pursuant to the healthcare provider's policiesand procedures.PLAINTIFF'S MEDICAL PROVIDERS:Any and all personnel, staff, employees and/or custodian(s) of records for:Christopher GambleDiana GarrettFort Bend County EMS5855 Sienna Springs WayMissouri City, Texas 77459Any and all personnel, staff, employees and/or custodian(s) of records for:Conrado Ordonez, MDMary E. Davidson, MDAmitabh Shukla, MDOakbend Medical Center22003 SW FreewayRichmond, Texas 77469(281) 238-0443Any and all personnel, staff, employees and/or custodian(s) of records for:Nelson Uzquiano, MDJosh Lucas, MDFort Bend Imaging Inc.14835 Southwest FwySugar Land, Texas 77478(281) 342-4995Any and all personnel, staff, employees and/or custodian(s) of records for:Surya Raghuthu, MDAce Pain Management1235 Lake Pointe Pkwy #103Sugar Land, Texas 77478(832) 532-0050Any and all personnel, staff, employees and/or custodian(s) of records for:William M. Colgin, DC, PCChiropractic Arts Center905 SilveradoRosenberg, Texas 77471Any and all personnel, staff, employees and/or custodian(s) of records for:Conrado J. Ordonez, MD5633 Avenue, Suite ARosenberg, TX 77471281-238-0443Any and all personnel, staff, employees and/or custodian(s) of records for:Amitabh Shukla, MDNeurology Clinic16605 Southwest Freeway, Suite 575Sugar Land, TX 77479281-341-1500Any and all personnel, staff, employees and/or custodian(s) of records for:Lon Le, MDComplete Pain Solutions1900 N. Loop West, Suite 160Houston, TX 77018713-461-3399Any and all personnel, staff, employees and/or custodian(s) of records for:Chad Porter, MDMatthew Dang, MDMemorial MRI & Diagnostic9434 Katy Fwy, Suite 408Houston, TX 77055713-461-3399Any and all personnel, staff, employees and/or custodian(s) of records for:Thomas Jones, MDSpine Institute of Southeast Texas107907 Memorial Hermann Dr., Suite 320Pearland, TX 77584713-987-7760Any and all personnel, staff, employees and/or custodian(s) of records for:Dr. Pradeep KodaliOrthopedic Surgery & Sports Medicine1429 Highway 6 S, Suite 304Sugar Land, TX 77478 Defendant hereby cross-designates and hereby reserve the right to call and/or rely upontestimony from any persons designated as experts by any other parties, but do not stipulate tothose persons' qualifications or to their methodologies for rendering any of their opinions.Instead, Defendant requires that all such persons sought to be qualified as experts first satisfy thegate-keeping obligations of the Court under Texas law. Defendant reserves the right to use portions of the live deposition testimony of any expertwitness called by any party to this lawsuit or any other person called by any party to this lawsuit,as expert testimony. Defendant reserves the right to call rebuttal witnesses, whose testimony cannotreasonably be anticipated at this time and any other expert witnesses for which an extension oftime or leave of court may be granted. Defendant reserves the right to withdraw the designation of expert witnesses and statepositively that any such previously designated expert will not be called as an expert witness attrial, and to re-designate same as a consulting expert who cannot be called by opposing counsel. Defendant reserves the right to supplement this designation with additional designationsof experts within the time limits imposed by the Court or any alterations of same by subsequentCourt Order or agreement of the parties, or pursuant to the Texas Rules of Civil Procedure and/orthe Texas Rules of Evidence. Defendant also reserves the right to withdraw the designation of any expert and to averpositively that such previously designated expert will not be called as a witness at trial and to re-designate same as a consulting expert only. Defendant reserves whatever additional rights it may have with regard to experts,pursuant to the Texas Rules of Civil Procedure, the Texas Rules of Civil Evidence, this Court'sruling concerning designation of experts for Plaintiff’s case-in-chief and rebuttal, and other lawsof the state. Page | 6 Respectfully submitted, LAW OFFICE OF AMY L. MITCHELL ___________________________________ Lee Kathryn Shuchart Bar Number: 18275900 1 East Greenway Plaza, Suite 1005 Houston, Texas 77046 (713) 667-6767 (866) 364-3121 Facsimile Shuchl1@nationwide.com ATTORNEY FOR DEFENDANT TERRANCE HLAVINKA CATTLE COMPANY and RAYMOND LEAL, JR. CERTIFICATE OF SERVICE I hereby certify that a true and correct copy of the foregoing document has been served incompliance with Rules 21 and 21a of the Texas Rules of Civil Procedure on the 11th day ofAugust 2022.Kevin W. GrilloReynaldo A. PenaPena Law Firm, PLLC205 N. Carrizo St.Corpus Christi, TX 78401Counsel for Plaintiff ___________________________________ Lee Kathryn Shuchart Page | 7 R. Alexander Mohr, MD Orthopedic SurgeryAugust 11, 2022Ms. Lee K. ShuchartLaw Office of Amy L. Mitchell1 East Greenway Plaza, Suite 1005Houston, Texas 77046Re: Lerma, Ubelestez Date of Injury: 5/5/2020Dear s. Shuchart,Thank you for allowing me to participate in this case. The following is a review of the records andmy opinions. If you have any questions, please do not hesitate to contact my office.I am an orthopedic surgeon currently in practice, actively treating patients at this time, and I havebeen in practice in the State of Texas since 2011. I am board certified by the American Board ofOrthopedic Surgeons My practice is focused on the management of spine conditions, bothorthopedic and neurological, and second opinions, including those caused by sport related,trauma and age related degeneration. I am a member of the American Academy of OrthopaedicSurgeons, the North American Spine Society and the Lumbar Spine Research Society, I am apartner in Advanced Orthopedics and Sports Medicine, Director of Orthopedics CHI St. Luke’sVintage, Director of The Comprehensive Spine Center North Cypress – HCA Houston Healthcare.Please see my attached CV for further details.The following is a review of the records and my opinions. I am familiar with the standard of carefor health care providers in the state of Texas and aware of the charges for medical care in thisregion. I reserve the right to amend or supplement my opinions in the future, based on receiptof additional information.RECORDS REVIEWED: Texas Peace Officer’s Crash Report Ace Pain Management Rehab and Physical Therapy Fort Bend County EMS Oakbend Medical Center Fort Bend County EMS Dr. Shukla Neurology Clinic LabCorp Lerma, Ubelestez Date of Injury: 5/5/2020 August , 2022 Page Chiropractic Arts Center Fort Bend Imaging Spine Institute Southeast TexasCURRENT MVA:Claimant is 61 year old male restrained driver involved in rear impact MVA on 5/5/20. Air bagsdid not deploy.PAST MEDICAL HISTORY:DiabetesLiver problemsStroke x2DVTHepatitisSeizure disorderArthritisDiverticulitisEpilepsyHyperlipidemiaSciatic herniaAppendectomyBack surgeryColonoscopy with polypectomyCholecystectomyI&D perineal abscessCarpal tunnel bilateral feetColostomy with reversalTendon repair in handsSUMMARY AND OPINIONS:On 5/5/20 Mr.Ubelestez Lerma, was the 61 year old restrained driver involved in a rear impactmotor vehicle collision. Airbags did not deploy. He reported via EMS to Oakbend MedicalCenter with complaints of injuries to the neck, upper and lower back. His physical examdemonstrated tenderness to his neck and back with mild tenderness to his right ankle. Heunderwent a complete evaluation by the emergency room physicians and staff. He underwent ing in the form of a CT scan of the brain, cervical spine, chest abdomen pelvis. All of thesestudies demonstrated no acute findings. He was noted to have hepatic steatosis. Left posteriorabdominal flank wall defect with herniated of fat. Possible Paget's disease of the left femur.Radiographs of the chest and right ankle demonstrated no acute abnormalities. All of theradiographic findings noted chronic findings. He was diagnosed with cervical and thoracicsprain. He was recommended to not return to work today return to the emergency Lerma, Ubelestez Date of Injury: 5/5/2020 August , 2022 Pagedepartment if symptoms worsen given a muscle relaxer and asked to follow up with his primarycare in 3 days if not improved.In his initial evaluation to Oakbend Medical Center, his pain did not radiate into the extremities.He had no radicular signs or symptoms. A thorough exam was performed, and he was found tohave a normal neurologic exam to motor and sensory function. There were no focal neurologicdeficits indicative of any internal injury to the spine, spinal cord or nerve roots. There was noevidence of acute, anatomic injury at the time of evaluation. By that I mean there was noevidence of fracture, dislocation, tendon or ligament disruption, significant injury to theintegument, or neurovascular injury. At most the claimant may have suffered a cervical andthoracic strain. This diagnosis was correctly made.The diagnosis of lumbar strain does not constitute an actual injury. This is non specific softtissue pain similar to that experienced by a weekend athlete who over exerts themselves orsomeone beginning a new exercise regimen. The mechanism of muscle strain in this individualis most likely the contraction of muscles as they attempted to maintain body position duringthe collision. Typically, this type of condition will heal spontaneously without active medicaltreatment. I acknowledge there is no good medical evidence to support formal treatment forsubjective pain complaints in the absence of actual anatomic injury or objective functionaldeficit. But, I also acknowledge that it is customary for many primary treating providers toassign treatment modalities such as chiropractic therapy to treat pain in spite of the lack ofevidence of efficacy. With that caveat, I can support a brief combination of modalities for up to4 weeks.My medical experience has included time caring for a variety of athletes from division 1 levelathletes to weekend Warriors. My clinical practice involves seeing patients with similar injuriesdaily, approximately 75 patients per week. I continue to manage injuries sustained duringmotor vehicle collisions and sports injuries frequently. I have utilized several methods oftreatment for subjective pain after an acute trauma without anatomic injury. This includesobservation, chiropractic therapy, physical therapy, acupuncture, and massage therapy. Themedical evidence does not support improved outcomes in long term pain relief with any ofthese methods relative to the others. My personal clinical experience supports this finding. Ihave not seen greater pain relief in my patients after acute trauma without anatomic injurywith active treatment simple observation. Therefore, it has become my practice over time tomanage these patients with active rest, anti inflammatory medication as needed, and earlyreturn to activities as tolerated. I will typically initiate active treatment if the patient does nothave significant improvement in symptoms in 4 6 weeks. This specifically applies when there isno evidence of anatomic injury as in this case.6/3/20 CT Cervical Spine performed at Fort Bend Imaging ($1,251) read by Dr. Lucas. IMPRESSION: Lerma, Ubelestez Date of Injury: 5/5/2020 August , 2022 Page · Cervical spondylosis and multilevel degenerative disc changer. Alignment maintained. No acute fracture is seen. There is mild to moderate multilevel degenerative disc changes as detailed with suspected moderate central canal stenosis at C6 C7, mild at C5 C6, as well as variable neural foraminal stenosis.6/3/20 CT Thoracic Spine performed at Fort Bend Imaging ($1,251) read by Dr. Uzquiano. IMPRESSION: · Degenerative changes with prior compression deformity of L1 and L2 with kyphoplasty cement in place. No acute compression fracture or subluxation. Neurostimulator device in place.6/3/20 CT Lumbar Spine performed at Fort Bend Imaging ($1,251) read by Dr. Lucas. IMPRESSION: · No acute fracture seen. Vertebroplasty changes noted at L1 as well as L2 with minimal loss of height at L1. Otherwise, no fracture seen. If there is concern for acute nondisplaced fracture follow up MRI recommended. Otherwise, lumbar spondylosis and multilevel degenerative disc changes as detailed.6/3/20 CT Right Ankle performed at Fort Bend Imaging ($1,107) read by Dr. Uzquiano. IMPRESSION: · No fracture or subluxation identified. 9/11/20 Follow up evaluation performed at Ace Pain Management Rehab and Physical Therapy EMG/NCV evaluation of the neck and upper extremities. · EMG/NCV evaluation of the neck and upper extremities o IMPRESSION: § Showed C 7 radiculopathy § Bilateral carpal tunnel syndromeClaimant was seen and evaluated at the spine Institute of South East Texas. 12/2/21. Hepresented with complaints of neck pain radiating down both arms and associated with tinglingto the fingers. Pain level was described as 10 out of 10. With having failed to improve withprevious injections and therapy. His exam was reported as follows:GENERAL: Alert and oriented x 3; well developed and nourished; appropriately groomedE/N/T: normal EACs, TMs, nasal/oral mucosa, teeth, gingiva, and oropharynx;NECK: Minimal Extension and flexion, 10 degrees of bilateral rotation, +1TP trapezius;RESPIRATORY: Symmetric rise of chest, unlabored breathingCARDIOVASCULAR: 2+ radial pulses, regular rate Lerma, Ubelestez Date of Injury: 5/5/2020 August , 2022 PageGASTROINTESTINAL: Soft, non tender, non distendedINTEGUMENTARY: No suspicious lesions, rashes nor molesMUSCULOSKELETAL: Normal range of motion, strength and tone;NEUROLOGICAL: cranial nerves, motor and sensory function, reflexes, gait and coordination areall intact;PSYCHIATRIC: appropriate affect and demeanor; normal speech pattern; grossly normal memory;He was diagnosed with cervical radiculopathy.1) Will order a CT myelogram C spine to r/o nerve impingement.2) Will order 4 views C spine to evaluate for instability. 3) Activity as tolerated.4) Continue current medications.5) F/u with me after imaging complete.He followed up 3/28/22. The report was that his pain was worsened since his previous visitthough at both visits his pain was rated 10 out of 10. There is report of review of CT scan of thelumbar spine from Complete MRI. Musculoskeletal exam demonstrates· Musculoskeletal o Back pain o Pain to bilateral upper extremity o Pain to bilateral legs o Neck pain · Neck o Minimal extension and flexion o 10 degrees of bilateral rotation o Trapezius tender to palpation DIAGNOSIS: · Spinal stenosis, cervical region PLAN: · Offered 3 C7 ACDF · Prescription for c collar brace for maintenance of sagittal balance and post operative pain control · Continue meds · Follow up after surgeryA 4 level anterior cervical discectomy and fusion was recommended. Evidence based medicinesupports the use of anterior cervical discectomy and fusion surgery in the face of spinalinstability, tumor, infection, cervical nerve root compression, cervical spinal compression. Theguidelines have been published by The North American Spine Society www.spine.org. Thereview of records does not adequately support the use of this highly invasive extensive surgery Lerma, Ubelestez Date of Injury: 5/5/2020 August , 2022 Pageon a medically ill gentleman. There is no record of the requested CT myelogram. The CT scanof the cervical spine would for the vast majority of spine surgeons not be adequate to plan sucha massive surgery. The EMGs do not support the use of this surgery. EMGs only documentradiculopathy at the C7 level. No radiographic imaging of instability was provided. The visit of12/2/21 suggested ordering 4 views of the cervical spine with flexion extension views to ruleout instability. I have no record of these having been performed. The patient's past medicalhistory and in particular past interventional pain and spine surgery history is extensive. Theaforementioned surgery is not warranted.The primary diagnosis from the motor vehicle collision appears to have strain which can betreated with physical therapy at most.SURGICAL ESTIMATE:Proposed C3 C7 ACDF Cervical Cpts- 22551, 2552X3, 22846, 22853 X4, 20930, 69990, 10180The final 2 codes in the proposed billing sequence are not appropriate.CPT code 6990 use of microsurgical techniques in spine surgery. CPT code 69990 is eligible forseparate reimbursem*nt only with procedure codes that CMS has designated as eligible withoperating .Do not bill 69990 because it is included in 22551 per CPT guidelines. Even though thecode descriptor for 22551 does not specifically say 69990CPT code 0180CPT code (Incision and drainage, complex, postoperative wound infection)would never be reportable for the same patient encounter as the procedure causing thepostoperative infection. It may be separately reportable with a subsequent procedure,depending upon the circ*mstances. It is my sincere hope that this procedure if performed doesnot result in a postoperative wound infection.The surgical cost estimate is inflated.Proposed C3 C7 ACDF Cervical Cpts- 22551, 2552X3, 22846, 22853 X4, 20930, 69990, 10180Professional $47,831.39Neuromonitoring: $18,000.56Cervical Brace$ 3,500.00Spring + Heights HospitalFacility Fees $160,602.80 1Implants $50,000.00 1 $50,000.00Anesthesia $5,000.00 1 $5,000.00IONM $2,500.00 1 $2,500.00Inpatient Stay $0.00 0 $0.00 TOTAL $218,102.80Reasonable charges for cervical fusion surgery $5000 10,000 surgeon’s fee $60,000 80,000 facility fee Lerma, Ubelestez Date of Injury: 5/5/2020 August , 2022 Page $1500 2500 Anesthesia feeThis evaluation has been conducted based on the medical record documentation provided withthe assumption that the material is true and correct. If more information becomes available, anadditional service/report/reconsideration may be requested. Such information may or may notchange the opinions rendered in this evaluation. This opinion is based on clinical assessment ofthe patient's records and documentation only.Sincerely,R. Alexander Mohr, MDBoard certified, fellowship trained Orthopedic surgeon CURRICULUM VITAE LEXANDER OHR MDERTIFICATIONS MERICAN OARD OF RTHOPAEDIC URGERY ERTIFICATION CURRENTDUCATIONNDERGRADUATE TAH TATE NIVERSITY OGAN TAH AJOR IOLOGY INORS HEMISTRY AND HILOSOPHY UM AUDE EDICAL CHOOL NIVERSITY OF TAH CHOOL OF EDICINE ALT AKE ITY TAH EDICAL OCTORATENTERNSHIP NIVERSITY OF TAH OSPITALS AND LINICS EPARTMENT OF RTHOPEDICS AKE ITY TAH HAIRMAN AROLD UNN MD 2001-2002ESIDENCY NIVERSITY OF TAH OSPITALS AND LINICS EPARTMENT OF RTHOPEDICS ALT AKE ITY TAH HAIRMAN AROLD UNN MD 2002-2006ELLOWSHIP NIVERSITY OF ISCONSIN EPARTMENT OF RTHOPEDICS AND EHABILITATION PINE ELLOWSHIP ADISON ISCONSIN CHAIRMAN FELLOWSHIP DIRECTOR HOMAS DEBLICK MDCADEMICS NIVERSITY OF ONNECTICUT EALTH ENTER SSISTANT ROFESSOR RTHOPEDIC AND EUROSURGERY, NIVERSITY OF ONNECTICUT EALTH ENTERR. LEXANDER OHR CURRICULUM ITAE AGE SSISTANT IRECTOR OMPREHENSIVE PINE ENTER EW NGLAND USCULOSKELETAL NSTITUTE 2007-2011 RACTICE DVANCED RTHOPEDICS PORTS EDICINE ARTNER TTENDING PINE URGEON EST OUSTON CURRENT PPOINTMENTS IRECTOR OF RTHOPEDICS CHI UKE INTAGE HASEWOOD ARK OUSTON CURRENT IRECTOR OF HE OMPREHENSIVE PINE ENTER ORTH YPRESS HCA OUSTON EALTHCARE ORTHWEST WY YPRESS CURRENT ONORS AND WARDS CADEMICS TAH TATE NIVERSITY AUDE USU EPARTMENT OF THLETICS CHOLAR OF THE EAR 1993 OLLEGE OF CIENCE EAN ONOR OLE 1989 LUE EY ONOR OCIETY 1990 LPHA PSILON ELTA ONOR OCIETY 1992 TAH TATE REEK CHOLAR OF THE EAR IGMA RATERNITY CHOLAR OF THE EAR PSILON HI ETA ONOR ATERNITY HARTER EMBER 1991 OUR ORNERS RTHOPEDI ESIDENT YMPOSIUM INNING EAM EMBER OF ESIDENT NOWLEDGE OMPETITION NIVERSITY OF TAH OSPITALS AND LINICS EPARTMENT OF RTHOPEDICS HAIRMAN AROLD UNN MD 2002-2006R. LEXANDER OHR CURRICULUM ITAE AGE AOA OREF-ZIMMER RESIDENT LEADERSHIP FORUM TTENDEE UNTINGTON EACH NIVERSITY OF TAH EPARTMENT OF RTHOPEDICS CADEMIC DMINISTRATIVE HIEF ESIDENT 2005-2006 AAOS/OREF/ORS ESIDENT LINICIAN CIENTIST EVELOPMENT ROGRAM TTENDEE AN NTONIO EXAS ONORS OLLEGE UTAH TATE NIVERSITY TAH TATE AN OF THE EAR INALIST IGMA RATERNITY ATIONAL LPHA NDUCTEE MA RATERNITY AN OF THE EAR TAH TATE ANHELENIC AND NTERFRATERNAL OUNCIL AN OF THE EAR EDICAL CHOOL NIVERSITY OF TAH CHOOL OF EDICINE HE MERICAN CADEMY OF EUROLOGICAL AND RTHOPAEDIC URGEONS CIENTIFIC CHOLARSHIP OF ENSEN URGICAL PECIALTY CHOLARSHIP MERICAN EART SSOCIATION EDICAL TUDENT ESEARCH ELLOWSHIP 1998-1999 ATIONAL NSTITUTES OF EALTH RIEF NVESTIGATORS RANT 1996-1997 OF HARLES CADEMIC CHIEVEMENT CHOLARSHIP 1995-1996 THLETICS TAH TATE NIVERSITY EPARTMENT OF THLETICS NCAA DIV ULL THLETIC OOTBALL CHOLARSHIP 1994 ARSITY ETTERMAN 1991-1993 CADEMIC MERICAN AND AS EGAS OWL HAMPIONR. LEXANDER OHR CURRICULUM ITAE AGE NIVERSITY OF TAH CHOOL OF EDICINE NTRAMURAL ED OCCER -CAPTAIN HAMPIONS 1997 AND 1998 RGANIZATIONS UTAH TATE NIVERSITY USU THLETIC OUNCIL TUDENT AT ARGE AND INANCE -COMMITTEE 1993-1994 USU CIENCE OUNCIL HAIRPERSON 1993-1994 IGMA RATERNITY RESIDENT 1993-1994, ICE RESIDENT 1992-1993, AND CHOLARSHIP HAIR NTER-FRATERNAL OUNCIL RESIDENT 1993-1994 AND UB FOR ANTA HAIR 1992-1993 TAH PECIAL LYMPICS OLUNTEER 1991-1993 AND UEST PEAKER 1993 NTER-MOUNTAIN RGAN ECOVERY YSTEMS USU ONOR ARD IGNATURE RIVE HAIRPERSON NIVERSITY OF TAH LDS OSPITAL EDICAL THICS OMMITTE ARTICIPANT PRESENT EST OF MERICA AY O TO RUGS TUDENT THLETE OLUNTEER AND OORDINATOR 1989-1993 NIVERSITY OF TAH CHOOL OF EDICINE MERICAN CADEMY OF EUROLOGICAL AND RTHOPAEDIC URGEONS NVITED EMBER AMERICAN EDICA SSOCIATION STUDENT SECTION ICE- RESIDENT 1996-1997 WESTERN EGIONAL AMA TUDENT ONVENTION VENT OORDINATOR 1997-1998 EDICAL CHOOL LASS THIRD EAR LASS -PRESIDENT 1997-1998 SOCIAL HAIR 1996-1997 HILANTHROPY HAIR 1995-1996 TAHNS GAINST UNGER OOD RIVE AND UB OR ANTA CHOOL OF EDICINE COLLEGE OUNCIL EMBER 1995-1996 CADEMIC EACCREDIDATION OMMITTEE TUDENT HAIR 1996-1997 STUDENT FFAIRS OMMITTEE EMBER 1997-1998 OURTH TREET OMELESS HELTER OLUNTEER TUDENT HYSICIAN 1995-1996R. LEXANDER OHR CURRICULUM ITAE AGE NTERNATIONAL ED ROSS UNDRAISING OLUNTEER IBLIOGRAPHY RIGINAL EER EVIEWED UBLICATIONS1. BRODKE DS, OLLOGLY OHR GUYEN AILEY AT, ACHUS DYNAMIC CERVICAL PLAT BIOMECHANICAL EVALUATION OF LOAD SHARING AND STIFFNESS SPINE UN 15;26(12):1324-9.2. PETERS CL, OHR ACHUS RIMARY TOTAL KNEE ARTHROPLASTY IN THE VALGUS KNEE CREATING A BALANCED SOFT TISSUE ENVELOP . J RTHROPLASTY ;16(6):721-9.3. BRODKE DS, ACHUS KN, OHR GUYEN EGMENTAL PEDICLE SCREW FIXATION OR CROSS LINKS IN MULTILEVEL LUMBAR CONSTRUCTS A BIOMECHANICAL ANALYSIS. SPINE 2001 -O ;1(5):373-9.4. GREIS CUDERI MG, OHR ACHUS URKS RT. LENOHUMERAL ARTICULAR CONTACT AREAS AND PRESSURES FOLLOWING LABRAL AND OSSEOUS INJURY TO THE ANTEROINFERIOR QUADRANT OF THE GLENOID J HOULDER LBOW URG -O ;11(5):442-51.5. PETERS CL, RAIG MA, OHR ACHUS IBIAL COMPONENT FIXATION WITH CEMENT FULL VERSUS SURFACE CEMENTATION TECHNIQU CLIN RTHOP ;(409):158-68.6. VAN OERUM ANDALL RL, OHR ONRAD EU, ACHUS OTATIONAL STABILITY OF A MODIFIED STEP CUT FOR USE IN INTERCALARY ALLOGRAFTS J ONE OINT URG ;85-A(6):1073-8.7. BRODKE DS, OLLOGLY ACHUS OHR GUYEN NTERIOR THORACOLUMBAR INSTRUMENTATION STIFFNESS AND LOAD SHARING CHARACTERISTICS OF PLATE AND ROD SYSTEMS. SPINE UG 15;28(16):1794-801.8. STEVENS PM, ILLIAMS OHR AIT ANALYSIS OF STAPLING FOR GENU VALGUM.R. LEXANDER OHR CURRICULUM ITAE AGE J EDIATR RTHOP -F ;24(1):70-4.9. BRODKE DS, OHR IOMECHANICS OF YNAMIC AND TATIC NTERIOR ERVICAL LATES SPINE LINE -A ;V(4):11-15.10. PETERS CL, RICKSON LOEPPER OHR EVISION TOTAL KNEE ARTHROPLASTY WITH MODULAR COMPONENTS INSERTED WITH METAPHYSEAL CEMENT AND STEMS WITHOUT CEMENT. RTHROPLASTY ;20(3):302-8. OHR RODKE DS. IXED V YNAMIC ERVICAL ATES OW TO HOOSE THE ROPER LATE URRENT PINION IN RTHOPAEDICS ;16(3):194-199 OHR RODKE DS. IXED V YNAMIC ERVICAL ATES OW TO HOOSE THE ROPER LATE ONTEMPORARY PINE URGERY SEP;7(9):1-6.13. CHECO FJ, OHR EGER WANSON ERVICAL PINE OSTOPERATIVE RACTICE ATTERNS ARIATIONS IN ERVICAL OLLAR MAGING AND HYSICAL HERAPY TILIZATION PINELINE OURNAL RESENTED BSTRACTS INTERNATIONAL RODKE DS, OHR GUYEN BN, AILEY AT, ACHUS YNAMIC ERVICAL LATES OES OAD HARING AUSE NSTABILITY UROPEAN ERVICAL PINE ESEARCH OCIETY ODIUM RESENTATION RODKE DS, OHR GUYEN BN, ACHUS EGMENTAL EDICLE CREW IXATION OR ROSS-LINKS IOMECHANICAL NALYSIS ORTH MERICAN PINE OCIETY ODIUM RESENTATION ANDALL RL, AN OERUM OHR ONRAD EU, ACHUS OTATIONAL TABILITY OF A ODIFIED TEPCUT FOR SE IN NTERCALLRY LLOGRAFTS USCULOSKELETAL UMOR OCIETY OSTERR. LEXANDER OHR CURRICULUM ITAE AGE4. BRODKE DS, OLLOGY OHR GUYEN ACHUS NTERIOR NSTRUMENTATION FOLLOWING ORPECTOMY ECONSTRUCTION IN THE HORACIC AND UMBAR PINE IOMECHANICAL TIFFNESS OF NTERIOR LATE VERSUS OD YSTEMS ORTH MERICAN PINE OCIETY ODIUM RESENTATION ATIONAL CUDERI MG, RIES PE, OHR URKS RT, ACHUS KN. LENOHUMERAL RTICULAR ONTACT REAS AND RESSURES FOLLOWING ABRAL AND SSEOUS NJURY TO THE NTEROINFERIOR UADRANT OF THE LENOID AAOS. ODIUM RESENTATION OH RODKE DS, HACHATRYAN GUYEN ACHUS KN. ULTILEVEL NTERIOR UMBAR NTERBODY AGES -VITRO IOMECHANICAL SSESSMENT MER CADEMY OF EURO AND RTHOP URGEONS WARD INNING ODIUM RESENTATION OHR ETERS CL, RAIG MA, ACHUS IXATION WITH EMENT IOMECHANICAL AND ADIOGRAPHIC TUDY OF ULL VERSUS URFACE EMENTATION ECHNIQUES IN ADAVERIC IBIAE ORS. OSTER OHR RODKE DS, OLLOGY GUYEN AILEY AT, ACHUS YNAMIC ERVICAL LATES OES OAD ARING AUSE NSTABILITY ORS. OSTER OHR OGGARTY DP, ETERS CL. ECHANICAL TABILITY OF THE EMENT OLYETHYLENE NTERFACE IN EMENTED OLYETHYLENE CETABULAR OMPONENTS AAOS. OSTER AN OERUM ANDALL RL, OHR ACHUS OTATIONAL TABILITY OF A ODIFIED TEPCUT FOR SE IN NTERCALLRY LLOGRAFTS AAOS. OSTER RODKE DS, OLLOGY OHR GUYEN AILEY AT, ACHUS YNAMIC ERVICAL LATES OES OAD HARING AUSE NSTABILITY CSRS. WARD INNING ODIUM RESENTATION RODKE DS, OLLOGY OHR GUYEN ACHUS NTERIOR NSTRUMENTATION FOLLOWING ORPECTOMY ECONSTRUCTION IN THE HORACIC AND UMBAR PINE IOMECHANICAL TIFFNESS OF NTERIOR LATE VERSUS OD YSTEMS CSRS. ODIUM RESENTATION RODKE DS, OLLOGY OHR GUYEN ACHUS NTERIOR NSTRUMENTATION FOLLOWING ORPECTOMY ECONSTRUCTION IN THE HORACIC AND UMBAR PINE IOMECHANICAL TIFFNESS OF NTERIOR LATE VERSUS OD YSTEMS RTHOPEDIC RAUMA SSOCIATION OSTERR. LEXANDER OHR CURRICULUM ITAE AGE RODKE DS, OLLOGY OHR GUYEN ACHUS NTERIOR NSTRUMENTATION FOLLOWING ORPECTOMY ECONSTRUCTION IN THE HORACIC AND UMBAR PINE IOMECHANICAL TIFFNESS OF NTERIOR LATE VERSUS OD YSTEMS COLIOSIS ESEARCH OCIETY OSTER OLLOGY RODKE DS, OHR UYEN BN, ACHUS YNAMIC ERVICAL LATES OES OAD HARING AUSE NSTABILITY CSRS. ODIUM RESENTATION EGIONAL1. PETERS CL, OHR ACHUS RIMARY OTAL NEE RTHROPLASTY IN THE ALGUS NEE REATING A ALANCE OFT ISSUE NVELOPE ESTERN RTHOPEDIC SSOCIATION OSTER LEOPER BS, ETERS CL, OHR EVISION OTAL NEE RTHROPLASTY ONG EMORAL AND IBIAL TEMS AUSE AIN OF EPT OF RTHOP HRINE OSPITAL OLEMAN ECTURESHIP ERIES ODIUM RESENTATION ETERS CL, OHR ACHUS RIMARY OTAL NEE RTHROPLASTY IN THE ALGUS NEE REATING A ALANCE OFT ISSUE NVELOPE ETCALF ONFERENCE ODIUM RESENTATION OHR ETERS CL, RAIG MA, ACHUS IXATION WITH EMENT IOMECHANICAL AND ADIOGRAPHIC TUDY OF ULL VERSUS URFACE EMENTATION ECHNIQUES IN ADAVERIC IBIAE ESTERN RTHOPEDIC SSOCIATION ODIUM RESENTATION OHR ETERS CL, RAIG MA, ACHUS HE NFLUENCE OF EMENTED EMORAL OMPONENTS ESIGN ON EMENT TRAIN -VITRO EMENT TRAIN NALYSIS URING INGLE EG TANCE AND TAIR LIMBING ESTERN RTHOPEDIC SSOCIATION OSTER OGGARTY DP, ETERS CL, OHR ECHANICAL TABILITY OF THE EMENT OLYETHYLENE NTERFACE IN EMENTED OLYETHYLENE CETABULAR OMPONENTS HRINE OSPITAL OLEMAN ECTURESHIP ERIES ODIUM RESENTATION NVITED UEST PEAKER MERICAN CADEMY OF EUROLOGICAL AND RTHOPAEDIC URGEONS NNUAL CIENTIFIC EETING CIENTIFIC CHOLARSHIP INNER RESENTATION EGAS EVADA ULY TAH PECIAL LYMPICS INTER AMES PENING PEECH FOR THE TAH PECIAL LYMPICS INTER AMES TAH TATE NIVERSITY AMPUS OGAN TAH OVEMBER 1992. Pamela S. Joslin MM, CPC, CMC, CMIS, CMOM, CMCO, CEMA, CMCA E/M San Antonio, TX 210.441.9321 psjoslin@gmail.com Accomplished professional offering extensive experience as a leader in the healthcare industry. Impressive background in training, quality management and a strong track record of ongoing process improvement that directly impacts the bottom line. Highly organized individual with strong attention to detail. Strong analytical skills coupled with clear communication, coding, billing and auditing skills to analyze documentation in medical records to assist with areas of risk and compliance. Areas of Expertise Billing/Coding Expert Certified Medical Coder Certified Medical Insurance Certified Chart Auditor Individual and Group Instruction Specialist Certified Compliance Curriculum Development Adult Education/TWC and ABHES Officer Classroom and Online Instruction PROFESSIONAL EXPERIENCE CEO, INNOVATIVE HEALTHCARE CONSULTING San Antonio TX July 201 currentOver 20 years of working in healthcare field, including practice management, revenue cycle management, billing and coding,auditing and compliance experience. Serves as classroom and on line instructor who is passionate about participants receivingquality education to stay actively engaged in their career goals and become “lifelong learners” to successfully navigate thecomplexity of today’s healthcare. Actively participates in medical practice assessments, coding/billing audits to assist practiceswith financial viability and sustainability goals and objectives. Passionate in working with practices to reach a level ofprofitability that allows them to thrive within a market and deliver consistent high quality patient care.Key Achievements: Review provider charges for “reasonableness” of products/services provided, provide required documents Review medical claims to detect unlawful or incorrect carrier payments Conduct quality assurance assessments and reviewed statistical samples Utilize current CPT, ICD 10 CM and HCPCS coding systems with emphasis on compliance and regulatory standards Provide summary of findings, recommendations training, compliance program, etc. to meet required standards QUEST COLLEGE San Antonio TX July 201 September 2018Medical Billing and Coding Instructor (PartTime)Present curriculum, with enthusiasm to assist student in achieving their educational goals. Motivate students to complete thecareer goals within the Medical Billing and Coding curriculum. Expose students, via personal experiences, on line research, otherinteractive tools to help them understand the scope of their career goals. Respect and manage the classroom according topolicies and procedures of the college.Key Achievements Prepare for each class in advance, start and end classes on time. Actively participate in instructor’s training and meeting Monitor attendance of students and retention efforts. Prepare weekly lesson plans (syllabi) (according to course objectives) COLLEGE OF HEALTH CARE PROFESSIONS San Antonio TX December 2018 currentMedical Billing and Coding Instructor (AdjunctPresent curriculum, with enthusiasm to assist student in achieving their educational goals. Motivate students to complete thecareer goals within the Medical Billing and Coding curriculum. Expose students, via personal experiences, on line research, andother interactive tools to help them understand the scope of their career goals. Respect and manage the classroom according topolicies and procedures of the college. Page of Pamela S. Joslin MM, CPC, CMC, CMIS, CMOM, CMCO, CEMA, CMCA E/M San Antonio, TX | 210.441.9321 psjoslin@gmail.comKey Achievements Prepare for each class in advance, start and end classes on time. Actively participate in instructor’s training and meeting Monitor attendance of students and retention efforts Prepare weekly lesson plans (according to course objectives) PRACTICE MANAGEMENT INSTITUTE San Antonio TX November 2014 July 2018Director of Education and Training/ConsultantProfessional classroom instructor/trainer on healthcare topics, such as CPT/ICD coding/billing, practice management andcompliance/auditing tracks for all medical specialties. Develop and maintain robust training programs for all aspects of RevenueCycle Management and instructor tools for going curriculum. Conduct on line and in classroom environment learning and nstruction training opportunities for Physicians, Practice Administrators, and their staff designed to focus on increasing staffcompetencies and efficiencies. Created annually and taught nationally to clients Annual Medicare Fee Schedule Program onRVU changes that impact reimbursem*nt physician fee schedules and overview of policy changes vital to practice success.Key Achievements: Certified ICD 10 Trainer Improved existing learning content aligning with certification exam process. Created enhanced training tools for instructors Created and maintained good working relationships with instructor team and clients Creator of Medical Chart Auditing (CMCA E/M) credential SAN ANTONIO GASTROENTEROLOGY ASSOCIATES, PA San Antonio TX August2012 June 2014Business Office ManagerRecruited and hired business office staff, measured performance and established improvements to enhance morale,productivity, accuracy, and customer service. Facilitated billing and collections processes. Conducted monthly/quarterlyphysician reporting that reflected trends in practice analysis for growth and successful strategic planning.Key Achievements: Successfully oversaw revenue cycle management operations of practice with 52 billing providers and multiple locations. Decreased denial rate by working with carriers on edit problems that prohibited claims from being paid first submission. Advocated for certified coders in the Business Office to improve coding accuracy and compliancy KAPLAN COLLEGE San Antonio, TX February 2011 October 2014Adjunct InstructorInstructor led course in Medical Practice Management Associate Degree Program. Prepared for courses by developingcurriculum and other course materials. Kept records of attendance and grades. Attended required training and evaluations.Key Achievements: Supported student learning by stimulating career thinking and focusing on career goals in the classroom. Partnered with students to overcome obstacles by providing tutoring opportunities. Actively involved with healthcare community organizations to enhance the MPM program and student preparedness for the career. Page of Pamela S. Joslin MM, CPC, CMC, CMIS, CMOM, CMCO, CEMA, CMCA E/M San Antonio, TX | 210.441.9321 psjoslin@gmail.com SPINE AND PAIN CENTER OF SAN ANTONIO San Antonio, TX February 2011 July 2012Practice AdministratorManaged revenue cycle operations of busy practice with multiple locations. Hired and recruited all business staff and measuredperformance. Worked with management team to coordinate business and clerical staff efforts for maximum efficiencies andeffectiveness throughout the clinic locations.Key Achievements: Reduced overhead expenses by working efficiently with accountant on improving billing and collections procedures. Stimulated future growth potential by conducting physician reporting that encouraged effective de 

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