South Carolina hospital claims vendor incorrectly billed insurers on its behalf

Greenwood, S.C.-based Self Regional Healthcare sued Financial Review Services, a medical bill auditor, for allegedly inappropriately billing payers on SRH's behalf, according to an Index-Journal report.

Here are four things to know.

1. This fall FRS filed 806 amended claims to payers and garnered $1.04 million in payments for SRH.

2. However, SRH claimed roughly 85 percent of the payments worth $855,101 resulted from incorrect claims. A May 21 court filing argued the respective claims violated an agreement between SRH and commercial payers or violated the hospital's billing and charging protocols. This included charging insurers twice for supplies and services, the report states.

3. An insurer notified the hospital the amended claims did not adhere to terms the payer and SRH agreed upon, Index-Journal reports. SRH said it is required to repay the bills, but it is seeking actual and punitive damages and a reprieve from any payment obligation to FRS.

4. FRS denied the allegations in a response filed June 12 and claimed SRH did not give the vendor access to its payer agreements. FRS seeks damages and more than $1.4 million from SRH for its auditing services, according to a counterclaim obtained by Index-Journal.

For the full report, click here

Copyright © 2024 Becker's Healthcare. All Rights Reserved. Privacy Policy. Cookie Policy. Linking and Reprinting Policy.

 

Featured Whitepapers

Featured Webinars