Education and Training Resources

Julie Lewis Hauf provides training and speaks around the country on handling claims involving insurance fraud and abuse, medical billing and coding, as well as general insurance topics. Classes are available from hour-long seminars to intensive day-long training on a variety of issues.


Favorable MSJ Win

The Orange County judge ruled in our favor on three separate issues: that Plaintiff’s failure to file a reply resulted in a waiver of their right to oppose our affirmative defenses; the clinic wasn’t licensed at the time to distribute DME, making the charge unlawful and not payable; and that requesting an invoice for durable medical equipment was a proper request under F.S. sec. 627.736(6)(b).

Cross at Fee Hearings

This video discusses questions to ask Plaintiff’s counsel during a fee hearing and how you can use those answers to make your points to the judge on a reasonable hourly rate and the time entries.

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Plaintiff’s Timesheet Analysis

One of the first steps I take when reviewing a file as a fee expert is to analyze and mark up a copy of the docket side by side with the Plaintiff's timesheets. This is the best way learn the story of a case, and can quickly highlight areas for potential review and reduction. Today's video discusses several items to focus on when doing this comparison.

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Limited Success Doctrine in Fee Hearings

This video discusses how to use the limited success doctrine in the evaluation of the other side's time, what to look for, what the defense expert can do to address these reductions, and what needs to be included in the court’s order where these arguments were raised at the fee hearing.

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Fee Hearings – LSOP Reports

This video discusses the many uses of LSOP reports. Whether you are looking for examples of template documents, need facts to defeat a multiplier, or are seeking other evidence to determine reasonable fees, this report can be a game changer. Whether I’m testifying as a fee expert or preparing one of my own files for a fee hearing, this is one of the first things I review.

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Adjuster Deposition Prep

This video discusses how to organize your claims file and prepare yourself to give an adjuster deposition. Also discussed are the three “boxes” you can put questions into regarding claims handling decisions, to better understand what information the other side is seeking and to more quickly locate the documents to support your answer.

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Billing for Spinal Decompression Procedures

How can you tell whether the right code has been used on the bill for a Plaintiff’s spinal decompression procedure? This video talks about how the AMA’s CPT guidelines can be utilized to ensure the correct code is charged.

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Surgery Checklist

Today’s video discusses items you can review in a plaintiff's surgical records to help make sure the charges are appropriate. Getting into the details is the starting point to get inflated bills back down to where they belong.

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Change to Florida's Summary Judgment Standard

What difference can one word make? Here, quite a bit, as Florida's Supreme Court has released an opinion amending Rule of Civil Procedure 1.510 to say that summary judgment is to be awarded if there is no genuine "dispute" as to any material fact, rather than any genuine "issue" as to any material fact, effective May 1, 2021. This change brings Florida in line with the federal summary judgment standard.

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Case Law Update - Attorney's Fees

This video discusses a recent 3rd DCA opinion related to attorney's fees where the court criticizes a plaintiff's expert for not generating a line-by-line opinion on the reasonableness of the time, rather just making a 10% across the board reduction, which was ultimately adopted by the trial court, along with the award of a 2.0 multiplier without evidence of one of the three prongs being satisfied. The 3rd DCA remanded for an order to be entered consistent with the defense's expert findings, 101 hours instead of 422 hours, as it was the only competent, substantial evidence on the record below. Also included is the court's take on what to do with costs for non-testifying experts, giving direction to the trial court to reconstruct a reasonable trial strategy that could have been used in an actual trial and award costs on the basis of that strategy.

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MSJ Win on 14 Day Treatment Provision

This video discusses the favorable ruling I received on a Motion for Summary Judgment in a PIP suit in Orange county related to proof of treatment within 14 days of an accident. Here, the carrier documented their file with the efforts of their investigation to secure written proof of treatment to trigger coverage, but the documentation was not submitted until after suit was filed. The claimant had discussed the treatment in their EUO, but did not submit any documentation for verification, despite multiple requests. Payment was made to the Plaintiff during litigation, with interest, but the court ruled that this was not considered a confession of judgment, meaning that no fees and costs were owed to the Plaintiff as a result.

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Transportation and OTC Drug Charges

Today’s video discusses both transportation and over-the-counter drug charges in a PIP setting, using them as a tool to focus on two helpful provisions of the Florida PIP statute. The first requires a provider not charge more to PIP patients than other patients seen in the practice. The second deals with the deadline to submit a revised claim if the provider feels something has been reduced or denied in error. Both can be very effective affirmative defenses, the latter particularly in files where the provider waits until suit has been filed (or much later into the litigation) to tell the carrier how they should have paid.

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ARNP Treatment

This video discusses an update to Florida's PIP statute effective July 1, 2020, adding treatment by an ARNP to the list of initial services and care in the 14 days after an accident that will trigger coverage. Items to confirm are present on an ARNP's required protocol are also outlined to ensure that the treatment is lawful and compensable.

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Unlawful Provision of Durable Medical Equipment

This video discusses questions to ask to determine whether the charges for Durable Medical Equipment (DME) included on a provider's bill are lawful. Also covered is guidance provided on DME issues by the HCPCS Level II coding book, to further assist in determining whether a DME should be compensable.

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Florida's Unattended Motor Vehicle Law

What is the liability of a car owner whose vehicle is taken after the keys are left inside? This video discusses Florida's unattended motor vehicle statute, exceptions that have been carved out, and the Legislature’s public policy reasons behind the law

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Minor Plaintiffs

How does your injured plaintiff being a minor change your investigation in a bodily injury case? This video discusses some alternatives to the typical background checks and information gathering to assist in building your defense in these cases.

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Out of State Policy No-Fault Benefits

What factors should you consider when processing PIP claims in Florida for a policy issued out of state? What additional items should be considered when defending that litigation? Today's video discusses steps to take and policy language you can use to your advantage when litigating another state's policy in Florida.

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Red Light, Green Light

There's more to rely upon than just witness statements. Today's video discusses documents you can obtain about the traffic signal pattern at an intersection to help sort out what happened, either pre-suit or during litigation.

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Disclosure Requirements for Self-Interested Referrals

Even when a referral itself is permissible, has it been done in the right way? Florida Statute sec. 456.052 sets forth the disclosure requirements by a referring health care provider - lack of compliance is a misdemeanor and can be grounds for disciplinary action by a provider's board. This video discusses what to look for and how to use this information to keep your damages down.

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Fraud in Part, Fraud in the Whole

What does it mean to "knowingly" submit false or misleading statements related to a claim or charges? The Florida PIP statute provides a defense to payment of claims in this situation. We discuss the term "knowingly" in this context as well as how this section of the PIP statute can be used in BI cases.

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Untimely Corrections

There's a section of the Florida PIP statute that will help prevent a provider from claiming in litigation that "I billed you like this, but you should have known to pay me like that." This video discusses a defense to consider in every PIP suit where the provider claims their billing "error" makes the carrier responsible for a higher payment than was initially made.

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Fee Hearings – Vol. 2

This next installment in our series on fee hearings addresses multipliers, specifically the required element of showing that the relevant market required a contingency fee multiplier in order for the client to obtain competent counsel.

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Hidden Cost of Facility Fees

A car accident isn't an investment opportunity. Find out how to spot and what to do when a physician's offices pays for the surgical center charge and places a much higher charge on their own bill.

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Hidden Cost of Facility Fees

A car accident isn't an investment opportunity. Find out how to spot and what to do when a physician's offices pays for the surgical center charge and places a much higher charge on their own bill.

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Fee Hearings - Vol. 1

First in a series, this video addresses some significant areas of reduction to consider on plaintiff's timesheets, as well as recent trends in fee hearing awards around Florida.

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Examinations Under Oath and Recorded Statements - Asking About Questionable Treatment

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Facet Injections - September 1, 2020

Three things to look for in your procedure bills for facet injections to make sure the charges are appropriate.

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