This ruling puts emergency physicians in a hard spot, but protects consumers. This goes back to the Prime/Kaiser scenario and more can be found under the related reading section here. There is a separate case pending with the California Supreme Court, so the matter is not closed yet by any means...
Posted to
The Medical Quack .... by Barbara Duck
on 11-23-2008
Filed under: Medically Related, Insurance, Hospital, health insurance, Health Care, Kaiser Permanente, Blue Cross, Balance Billing, Prime Healthcare, Venture Capital, Californa Medical Association, Insurance Reserves, Out of network care
This very extensive article examines various hospitals in Massachusetts and the cost of the same procedures at different hospitals, and then continues further to discuss how this happens; contracts with the insurers and the ability to use “branding” to command a higher rate, all the big centers do it...
Posted to
The Medical Quack .... by Barbara Duck
on 11-16-2008
Filed under: Medically Related, Insurance, Other Items of Interest, My Commentaries, Physicians, Hospitals, bankruptcy, Balance Billing, Transparancy, Debt consolidation, Vendors, Hosptials
The battle continues on balance billing, but it comes down to someone just paying the bill for health care once more. Are we looking for blood from a turnip here? Hospitals need money, doctors need money, contracts keep getting lower every year,so if 50% of our hospitals in the US were not...
Posted to
The Medical Quack .... by Barbara Duck
on 11-14-2008
Filed under: Medically Related, Insurance, healthcare, Balance Billing, Whistle Blower, Algorithms, formulas, Sofware, softwareHealth Insurance, WarrenBuffet, Property
I don’t know of one doctor or hospital that is not writing off balances of what the insurance companies are not paying. On top of that it is one administrative nightmare, medical assistants can’t get the time in the consultation rooms with the doctors as they are tied up on administrative functions...
Posted to
The Medical Quack .... by Barbara Duck
on 10-23-2008
Filed under: Medically Related, Insurance, Pharma/FDA News, healthcare, health insurance, Claims, Hospitals, bankruptcy, Balance Billing, Patients, Sicko
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...
Posted to
The Medical Quack .... by Barbara Duck
on 10-16-2008
Filed under: Medically Related, Insurance, healthcare, health insurance, Hospitals, bankruptcy, Balance Billing, Department of Managed Care
In California we are well aware of this with the recent news with Prime Health Care being challenged on this practice as they have no contracts with the insurers and charge their published rates for out of network care, and the patient is stuck in the middle, but from the other side of the coin, some...
Posted to
The Medical Quack .... by Barbara Duck
on 08-29-2008
Filed under: Medically Related, Insurance, My Commentaries, Hospital, health insurance, Physicians, Quest Labs, bankruptcy, Balance Billing, Health Insurance Coverage, Not for Profit Hospitals, Prime Healthcare
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...
Posted to
The Medical Quack .... by Barbara Duck
on 08-12-2008
Filed under: Medically Related, Insurance, health insurance, Hospitals, California, Balance Billing, Department of Managed Care