billing
publication date
Clinical Care
After running out of cancer medication, hospital delayed care, refused to pay $42K bill
Gus Mohamed, a nurse in St. Dominic's emergency department, got his last dose of chemotherapy in April, putting him in remission. "It was supposed to be one of the happiest days of my life," he said.
Finance
7 Areas CFOs Must Address for Organizational Viability
An upcoming CFO roundtable provides a peer-sharing platform to learn best practices for advancing a healthcare organization's financial health.
...
Strategy
Direct Provider Contracting: Keep It Simple, Stakeholders Tell CMS
For the most part, providers support the Direct Provider Contracting proposal put forward by the Centers for Medicare & Medicaid Services, with some stipulations and considerable tweaking.
...
Finance
Iowa Medicaid has been overbilled $25 million, but the state's collection efforts have serious flaws
Four years ago, the cremated remains of a long-dead nursing home resident sat unclaimed on a shelf inside a western Iowa funeral home. The body of another deceased resident, a veteran who had...
Finance
Why Health Insurers Don't Care About Big Bills
Patients may think their insurers are fighting on their behalf for the best prices. But saving patients money is often not their top priority. Just ask Michael Frank.
...
Clinical Care
Auditor "shocked" by massive billing schemes at rural hospitals
Rural hospitals across the country are closing at the highest rates in decades. Since 2010, 83 have shuttered. Desperate to stay open, some hospitals got caught up in dubious billing schemes. In...
Clinical Care
Texas ruling in hospital billing case sparks concern
Some health care officials worry a recent Texas Supreme Court ruling may have broader implications on how hospitals and health insurers negotiate billing rates.
Finance
Chargemaster 'Unreliable': Top Texas Court Orders Hospital to Disclose Reimbursement
North Cypress Medical Center's latest appeal is rejected and the hospital must obey a trial court's order that it provide details on its negotiated rates with payers as part of a civil suit.
...
Finance
Docs Billing Medicare Patients Directly? CMS Looks to Allow It
The new request for information follows up on an RFI last fall that received more than 1,000 responses.
...
Finance
False Claims Settlement: 5 Items in Banner's Integrity Agreement
The document outlines the terms to which Banner Health agreed under a settlement to end False Claims Act litigation brought by a whistleblower.
...
Finance
Banner False Claims Settlement is Plaintiff's Third
A repeat whistleblower has secured three settlements, with payouts totaling more than $6 million for herself, from three different health systems that employed her for short periods of time.
...
Finance
Whistleblower Suit Costs Banner Health $18.3M
A clinical documentation specialist worked only three months before resigning and accusing the health system of fraudulent billing practices.
...