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Anthem Blue Cross accuses hospital of lab test billing scheme

Anthem alleges that Reliance Labs keeps at least a portion of the specimen and conducts testing on it, while purportedly passing on a portion of the sample to SWMC for additional testing. The claim states that SWMC bills Anthem for some or all of this testing, representing that it performed services it had not. Anthems review of insurance claims submitted found that most of the urine samples for which SWMC billed Anthem were collected from patients who had no connection whatsoever with SWMC and by doing so, Anthem alleges SWMCs conduct is a violation of California law, which declares it unlawful for any health facility to charge, bill, or otherwise solicit payment from any patient, client, or customer for any clinical laboratory service not actually rendered by the person or clinical laboratory under his, her, or its direct supervision. Anthem requested medical records for 50 claims submitted by Sonoma West for urine drug testing. According to Anthem, SWMC personnel informed Anthem that the hospital held no records for any of the sample claims, even though SWMC submitted all 50 claims to Anthem. According to the Anthem notice, the company was then contacted by Neisha Carter Zaffuto, who represented herself as an employee of SWMC and offered to provide the requested records. Later, Anthem learned Zaffuto is actually the president of Medivance, a billing company in Florida. The PDHCD board called for a special meeting on Friday morning to discuss the claim sent from Anthem Blue Cross Senior Associate General Counsel Steven มาตรฐานทดสอบสิ่งทอ M. Cohen. The document is dated Feb.

For the original version including any supplementary images or video, visit http://www.sonomawest.com/sonoma_west_times_and_news/news/anthem-blue-cross-accuses-hospital-of-lab-test-billing-scheme/article_0608be34-16a4-11e8-be30-4be46ba0776e.html

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