I think we all remember this story from a short while back with the CEO responding about a patient and making a little too much information available relative to her diabetes records.  They were responding to a news report and it also ended up in the Los Angeles Times.  Prime was already being watched for the Kwashiorkor Malnutrition billing codes they were using.  I’ve done other posts too on billing software and the algorithms used for billing so there’s a little of both involved here with input and how the software does the ultimate coding as well.

Prime Healthcare Responds to Billing Practices–Flawed Data and Algorithms Once Again-Who Got Sold a Bill of Goods as Kaiser, Stanford & Other Hospitals Had a Ton of Kwashiorkor Malnutrition Billings

The patient just wanted restitution and wanted her records correct, which every patient should demand if they find errors.  In the meantime the hospital has it’s ongoing issues with Blue Cross.  What hospital today doesn’t have billing issues with at least one insurer.  BD 

Shasta Regional Hospital In California Suing Blue Cross/Blue Shield for Unpaid Medical Bills

A Prime Healthcare Services hospital in Redding broke state law when it publicized a patient’s confidential medical files in an effort to discredit a California Watch news report, state regulators say.

The state Department of Public Health on Tuesday issued five "deficiencies" against Shasta Regional Medical Center for what were described as repeated breaches of patient confidentiality last year.

At one point, the hospital CEO sent an e-mail to 785 people – virtually everyone who worked at the hospital – disclosing details from a 64-year-old diabetes patient’s confidential files, state investigators found.

The disclosures occurred as Prime was attempting to rebut a California Watch story on a supposed outbreak of a Third World nutritional disorder called kwashiorkor at the Redding hospital. The hospital had billed Medicare for treating more than 1,000 senior citizens for kwashiorkor over a two-year period, records show. 



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