teresa 040814_275x376Teresa Downie has greater than 39 years of experience in the healthcare field, both in inpatient and outpatient settings and as a medical auditor for post-pay reviewers. As a Registered Nurse, a Certified Clinical Documentation Specialist and a Certified Legal Nurse Consultant, she works with patients, physicians, healthcare facilities, attorneys, insurance companies, and utilization review organizations. As a certified clinical documentation specialist, Ms Downie works efficiently to balance cost effectiveness with accuracy in documentation, resource usage, reimbursement and improved quality patient care.

Ms. Downie’s healthcare experience encompasses a solid understanding of Federal and State (Medicare & Medicaid) regulatory requirements and guidelines affecting healthcare beneficiaries, healthcare providers, managed care organizations and physician practices. Her experience has included dealing with an independent review organization for a facility under a corporate integrity agreement.  Her clinical experience allows her to accurately blend rules and regulations with treatment plans and documentation which ultimately equals appropriate and optimal reimbursement as well as improved quality of care.

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