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August 2008

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Health Net to pay fines and penalties for unpaid chiropractic claims

August 27,2008 — Managed health-care company Health Net has agreed to pay $41 million in claims and fines for underpaying 88,000 New Jersey customers.

According to Banking and Insurance Commissioner Ste ven Goldman, Health Net had shortchanged customers on their out-of-network medical claims from 1996 to 2005, and on dental, mental health and chiropractic claims from 1999 to 2006.

The result of a state investigation, the $41 million

total includes a $13 million fine, $14 million to the underpaid customers, $12 million in interest and $2 million in other fees.

Reimbursements were mailed to current and former customers starting last month.

Health Net, once known as First Option Health Plan of New Jersey and Physicians Health Services of New Jersey, has 120,000 policyholders in New Jersey.

Sources: IFAwebnews.com, Newsday.com, The Star-Ledger - NJ.com, Cherry Hill Courier Post

 

 

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2008-09-29 17:02:13
Name: Valerie-Investigative Mgr.

Location: South Caroling

Sources: IFAwebnews.com, Newsday.com, The Star-Ledger - NJ.com, Cherry Hill Courier Post


Regarding Health Net shortchanging benefits - reimbursemnts.

What do you require that we can help with. Most files prior to 2005 are in warehouse - it is not required to put these PPO names on HCFA's - but I can do as much reasonable research within reason -so as to not DISRUPT daily schedule.

VERY PLEASED to know someone is looking out for chiro, I felt like we might be the last soldier for chirocare out here. GOOD JOB!


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