TAG:

billing service

Anthem Alleges $16M in Calif. Hospital Lab Fraud

CEO SUMMARY: In a lawsuit filed in the U.S. District Court for the Central District of California, Anthem and affiliated Blue Cross Blue Shield plans alleged that 37-bed Sonoma West Medical Center, a Florida lab testing company, a medical billing company, and others used a pass-through la…

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Anthem Seeks $13.5M from California Hospital

CEO SUMMARY: Anthem charged 37-bed Sonoma West Medical Center in Sebastopol, Calif., of engaging in an improper billing scheme to defraud Anthem and its affiliated Blue Cross and Blue Shield plans. In effect, the charge is a notification to SWMC that Anthem intends to sue SWMC and its…

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Anthem accuses tiny hospital of pass-through billing scheme

This is an excerpt from a 1,300-word article in the March 5, 2018, issue of THE DARK REPORT. The complete article is available for a limited time to all readers, and available at all times to paid members of the Dark Intelligence Group. CEO SUMMARY: THE…

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Understanding the Future Of Laboratory Medicine

CEO SUMMARY: Healthcare’s transformation is now far enough along that most clinical labs and pathology groups are either feeling the financial pain or are excitedly developing ways to deliver more value from lab testing services. On April 26-27, at the 21st annual …

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More AP Consolidation: Aurora Buys Two Groups

CEO SUMMARY: Seeing the changes overtaking pathology practices, Brazos Valley Pathology decided to sell two of its group practices to Aurora Diagnostics. Last month’s transaction was not designed to fix financial problems nor was it because of retiring pathologists. Rather, it …

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May 28, 2013 “Intelligence: Late Breaking Lab News””

Globalization of laboratory medicine continues to move forward. Two recent examples illustrate this trend. Earlier this month, the University of Pittsburgh Medical Center (UPMC) announced that it had entered into an agreement with the Citizens Hospital of Hyderabad, …

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Four Labs and Billing Company Pay $140,000 Fine in HIPAA Case

WHEN A BILLING SERVICE company disposes of patients’ lab test records, it should do so in compliance with federal and state privacy rules. That means all protected health information (PHI) should be shredded or incinerated. Four pathology groups in Massachusetts learned this lesson the hard way wh…

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Medicare Extends 5010 Implementation for a Second Time, Effective July 1, 2012

FACED WITH THE FACT that many payers were not ready to implement the 5010 standard under the Health Insurance Portability and Affordability Act (HIPAA), on March 15, the federal Centers for Medicare & Medicaid Services (CMS) announced a second delay in enforcement of the standard…

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Pathology Records Found At Massachusetts Dump

CEO SUMMARY: Pathologists at four Massachusetts hospitals got a powerful reminder recently that a breach of protected health information (PHI) can occur at any time for the most unexpected reason. Earlier this month, the Boston Globe reported that the pathology reports and patien…

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Clarient, Generation Health, GenMark, Osmetech, Laboratoire Cerba, UCLA Med Center

CLARIENT INKS PACT WITH GENERATION HEALTH FOR GENETIC TESTING PAYER PRE-AUTHORIZATION OF GENETIC TESTS is the reason for the newly-announced contract between Clarient, Inc., and Generation Health, Inc., of Upper Saddle River, New Jersey. An…

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