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Prime Healthcare Settles Lawsuit for $1.2 Million – Balance Due Billing in California

Posted May 24 2010 10:40pm

Prime Healthcare had been seeing out of network Kaiser Permanente patients and does not have contracted rates with Kaiser or any other insurance carriers and bills image their normal and customary fees.   Recently in the news Prime Healthcare had also been bidding on IHHI hospitals here in Orange County and lost the bid on the chain.

Patients were receiving balance due bills and Prime was in court with Kaiser as well and the outcome of that portion of the balance due billing is still undecided.  Patients who received and paid balance due bills will receive a refund.  Half the settlement will go to Prime's charity foundation, and six clinics will split the rest evenly.   With the settlement, Prime did not have to admit fault.  BD

The owner of four Orange County hospitals will pay $1.2 million to settle a lawsuit brought by the state after patients were billed for charges owed by image their HMOs.

The California Department of Managed Health Care announced Monday that Prime Healthcare Services would refund any improperly collected payments and contribute $1.2 million to community clinics, which treat the uninsured. Prime owns West Anaheim Medical Center, Huntington Beach Hospital, La Palma Intercommunity Hospital and Garden Grove Hospital.

Michael Sarrao, attorney for Prime, said about six or eight Kaiser patients paid a few hundred dollars after receiving the collection letters. He said that money has been returned. Ehnes said an audit is under way of Prime's billing records from the past six years to see if any patients were balance billed. If so, they will receive refunds with interest.

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