Search results
Results from the WOW.Com Content Network
The Sunshine Act requires manufacturers of drugs, medical devices, biological and medical supplies covered by the three federal health care programs Medicare, Medicaid, and State Children's Health Insurance Program (SCHIP) to collect and track all financial relationships with physicians and teaching hospitals and to report these data to the Centers for Medicare and Medicaid Services (CMS).
In order to be clear on the payment of a medical billing claim, the health care provider or medical biller must have complete knowledge of different insurance plans that insurance companies are offering, and the laws and regulations that preside over them. Large insurance companies can have up to 15 different plans contracted with one provider.
Quest Diagnostics set a record in April 2009 when it paid $302 million to the government to settle a Medicare fraud case alleging the company sold faulty medical testing kits. It was the largest qui tam ( whistleblower ) settlement paid by a medical lab for manufacturing and distributing a faulty product. [ 51 ]
Diagnostic information specialist Quest Diagnostics will acquire the lab-related clinical outreach service operations of California-based hospital system Dignity Health, serving doctors and ...
Hospital labs may also outsource their lab, known as outreach, to run tests; however, health insurers may pay the hospitals more than they would pay a laboratory company for the same test, but as of 2016, the markups were questioned by insurers. [29] Rural hospitals, in particular, can bill for lab outreach under the Medicare's 70/30 shell rule ...
Discover the latest breaking news in the U.S. and around the world — politics, weather, entertainment, lifestyle, finance, sports and much more.
The deductible must be paid in full before any benefits are provided. After the deductible is met, the coinsurance benefits apply. If the PPO plan is an 80% coinsurance plan with a $1,000 deductible, the patient pays 100% of the allowed provider fee up to $1,000. The insurer will pay 80% of the other fees, and the patient will pay the remaining ...
Get AOL Mail for FREE! Manage your email like never before with travel, photo & document views. Personalize your inbox with themes & tabs. You've Got Mail!