This is not a big pool and you really have to be on your toes to get in here a this is for people who have been turned down and have pre-existing conditions. 7100 enrollees is the maximum so if you are enrollee number 7101, you are out of luck. Even with being accepted, the rates are not...
Doctors and hospitals can’t balance bill, but the Department of Managed Care doesn’t have the authority yet to enforce? This brings about a very good question of who will enforce this. Is this a provision with no teeth? Obviously this is good for patients as you come out with a bill...
Posted to
The Medical Quack .... by Barbara Duck
by
The Medical Quack
on
Sat, Dec 6 2008
Filed under:
Filed under: Medically Related, Insurance, Hospital, Physician, healthcare, health insurance, CMA, California, Balance Billing, Department of Managed Care
We still live in a risk management world, one where the Department of Managed Care is shadowed by the power of the insurance companies; laws and regulations just seem to make everyone miserable these days. No matter how you look at it, all the problems these days come from one source, lack of payment...
This goes back to the situation with Prime Health Care hospitals. Prime owns several hospitals in California and does not have contracts with the insurance companies, and has the ER rooms to accommodate all. When the insurer pays what they feel is owed and the charges go beyond this...