Medical consultant to health insurers, peer review organizations, and companies developing clinical software and medical products.
- Board Certified in Quality Assurance/Utilization Review
- Public Health/General Preventive Medicine
- Medical Management
- Insurance Advisor License
- Lessons for Providers from a Purchaser’s Perspective
- Tools for the Task: The Role of Clinical Guidelines
- Assisting senior citizens evaluate their options among Medicare HMOs
Robert J. Bargar, M.D., has extensive experience as a medical director and medical consultant to health insurers, peer review organizations, and companies developing clinical software and medical products.
He also serves as a clinical expert witness in cases involving medical benefits and medical fraud and abuse.
Medical Director for a major health insurer for Claims Policy and Regulatory Affairs, clinical reviewer and Medical Consultant to the New Product Research and Development section developing a national transplant network as well as enhancing automated clinical intelligence for claims processing.
Senior Review Physician for a state peer review organization conducting physician-to-physician discussions of patient care for pre-admission and continued stay authorization. Conducting retrospective chart reviews for medical necessity. Coordinator and lead clinical designer of team developing clinical software to manage duration of disability. Review physician supporting Medical Appropriateness Protocols implementation.
Expert witness in fraudulent billing case and in case involving the propriety of union health benefit funds expenditures.
Dr. Bargar also serves as the Chief Medical Officer of OptiMed Physician Review and a staff physician and director of training and clinical training in the Cosmetic Laser Clinic, Burlington, MA. Previously, he was Associate Medical Director for GMIS where he assisted in the clinical design of ClaimCheck and the development of a clinical profiling system. Prior to GMIS, Dr. Bargar was Senior Scientist at the Health Data Institute where he provided clinical directing to consulting assignments. Dr. Bargar received his A.B. from Harvard College, his M.D. from Tufts University School of Medicine and his S. M. in Health Sciences Administration from the Harvard School of Public Health. He served his residency in radiology at the Lahey Clinic. He was Medical Director for a Connecticut Community Health Center while a commissioned officer in the USPHS, National Health Services Corps. He is a Licensed Insurance Advisor and a member of several professional societies.
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