The data, new findings by the Institute of Health and Socio-Economic Policy, the CNA/NNU research arm, is based on data from the California Department of Managed Care.Claims denial rates by leading California insurers, for the first three quarters of 2010, were: PacifiCare – 43.9% Cigna – 39.6% Anthem Blue Cross – 27.3% HealthNet – 24.1% Blue Shield – 21.9% Kaiser Permanente – 20.2% Aetna – 5.9% Since 2002, these seven… [read post]

(read the comments section of Blue Cross Watch: California Hospitals Being Routinely Defrauded for an example). [read post]

Use of DSM in the Law: the Doctors Need to Recognize this Reality in DSM-V - Criminal law attorney Terry Lenamon blog on his blog, Terry Lenamon on the Death Penalty HealthNet breach affects 1.9 million individuals - Washington DC lawyers Steve Fox and Vadim Schick of Post & Schell on the firm's Health IT Law Blog New ED CA Decision is a Feast of First-Party and Third-Party Insurance Coverage and Bad Faith Principles - Los Angeles attorney Eric Schindler of… [read post]

Tanha, who's our VP of Network Development, spent twenty years in California developing and managing networks for Aetna, Blue Shield and HealthNet, and she has duplicated those requirements internally here in the company as well. [read post]