Obtaining Authorization While Patient Is In House
June 29, 2022 4:52 pmMYTH: MA Plans are not required to respond to an inpatient authorization request. FACT: MA Plans ARE required to respond to an inpatient authorization... View Article
Press Releases
Community Rallies Around Yorba Linda Teen in Need of Operation
April 6, 2019 5:57 pmERN in the news! This morning, I saw this piece aired by Channel 5 of a young boy we successfully... View Article
How to Challenge Improper Denials of Emergency and Post-Stabilization Services
December 4, 2018 11:00 amINTRODUCTION As a provider in the acute medical setting, you have undoubtedly experienced the difficulty in obtaining prompt reimbursement for... View Article
Can an HMO make a medical decision without looking at medical records?
February 27, 2018 10:31 amSometimes you are the only thing that stands between the single crushing blow of HMO and a patient or provider.... View Article
24 Hour UM Access
December 8, 2017 12:14 am“Hello, you have reached the UM Department. We are open Monday through Friday, 8 a.m. to 5 p.m. Please leave... View Article
CalPERS DENIES AUTHORIZED MEDICAL CARE FOR DECEASED MEMBER
September 23, 2016 9:54 am“Justice will not be served until those who are unaffected are as outraged as those who are.” – Benjamin Franklin... View Article
VHA CLAIMS PAYMENT BACKLOG CONTINUES: TIME IS OF THE ESSENCE
March 10, 2016 6:22 pmNever leave that till tomorrow which you can do today. Benjamin Franklin. One of the most exposed issues within... View Article
DO IT….OR ELSE: WHY IS THE VETERANS HEALTH ADMINISTRATION REQUIRING AMBULANCE PROVIDERS TO SUBMIT HOSPITAL RECORDS?
January 6, 2016 7:22 pmAs we express our gratitude, we must never forget that the highest appreciation is not to utter words, but to... View Article
FOR IMMEDIATE RELEASE: NON-PANELED CCS DENIALS
December 29, 2014 1:00 pmCypress, CA, December 29, 2014 – Through our regulatory representation and continuous monitoring for rising trends, it has become apparent... View Article
(PRESS RELEASE UPDATE) DELAY, DENY, UNTIL I DIE: The waiting room is the new combat zone.
June 18, 2014 12:00 pmScandal, controversy and problems at the VA have existed for years. The FBI is now involved in a criminal investigation... View Article