List of Labs with hospital billing schemes

Lifebrite in Atlanta, GA. Numerous independent labs throughout the country are billing through the hospitals they purchased.

 

Take a close look at the Vitas Laboratory (CLIA No.04D2126474 CLIA No.51D2126330) MedTest Laboratories (CLIA No. 51D2098204) Universal Clinical Laboratories (CLIA No. 39D2116966) scam. There's plenty of labs billing through these CLIAs.

 

Surprise Valley Community Hospital in Cedarville California. Beau Gertz is at it again after the Putnam meltdown.

 

Look closely at Atrium Medical Center at Corinth.

 

Those texas cowboys… amarillo, texas specialty hospital of plum creek

 

https://www.cbsnews.com/news/rural-hospitals-big-insurance-reimbursements-chestatee-regional/

 

Aaron Durall is a piece of work.

 

A handful of labs are billing through Cimarron Memorial Hospital at 100 S Ellis St Boise City OK 73933. This has been going on for some time.

 

The upstanding folks over at ON3 Healthcare have been billing through Pike County Memorial Hospital at 2305 Georgia St Louisiana, MO 63353 for some time. Word is a handful of labs are billing through there.

 

I was approached to bill my BCBS, UHC and Cigna claims through Vitas Laboratory, CLIA 04D2126474. I would become a "reference" laboratory for their lab. Hell, they're advertising this shit on their website!

"Vitas Labs also offers a solution for out-of-network labs. We have national contracts with the top insurance providers, allowing us to provide in-network solutions for labs in need. Don't let contractual restrictions limit your growth potential. Contact us today."

https://www.vitaslabs.com

I was told that they're doing this with 20 labs and signing more every week. They said they have an "in" with senior management at Blue Cross. Shady!!!

 

Reference lab billing is legal. That’s why hospital partners will win the CIVIL suits. I am sure the crooked insurance companies pushed the feds to indict, but If the law is not broken, can not indict. Sorry to burst your bubble!!

 

There is a 70/30 rule for CLIA moron. The lab must perform 70 percent of the tests in house and only send out 30%. The hospitals usually have this covered because of the inpatient work. The problem is that so many drugs are tested for in a panel that this will put their CLIA certificates in jeopardy. They will still be cable to perform in-patient testing, but the OP testing will be an issue. This is how the insurances will win. The other issue is that the hospital does not control the work, the reference lab controls the work. This means it is a pass through scam that the insurers will win on as well. The hospitals stand zero chance of winning and will most likely lose their in network status!

 

“The problem is that so many drugs are tested for in a panel that this will put their CLIA certificates in jeopardy.”

This again shows someone who knows little acting like they know a lot. A lab has to follow physician orders. What a physician orders has nothing to do with CLIA.

“They will still be cable to perform in-patient testing, but the OP testing will be an issue.”

Wrong again. Again billing and running samples are two different things. It is number of samples run, not billing.

“The other issue is that the hospital does not control the work, the reference lab controls the work. This means it is a pass through scam that the insurers will win on as well.”

Again completely wrong. You just defined reference billing and now equate it to complete pass through billing. Again you are a troll, who knows just enough to be dangerous.

“The hospitals stand zero chance of winning and will most likely lose their in network status!”

Again this is your naive nature speaking again. In rural settings, the hospitals dictate private paying sources not the insurance providers. See how quickly bcbs bends over when hospitals stop accepting them. Secondly, dealing with private insurance and HMOs is hell (WellCare and Humana especially). Traditional Medicare and Medicaid are the easiest to deal with in hospital billing.

Single payer insurance will be a God send to labs. Private insurance companies hate it, but the in network game monsensenwill be over. You will have a level playing field, and all labs will be given a chance to succeed. Lastly, this above poster is why you have to be careful when reading things online. He is beyond incorrect, and quite frankly sounds like a simpleton.

 

You don't have to collect co pay or deductible if your a lab in a critical access hospital performing outpatient services.

 

The Vitas pass through billing scheme has been going on since last summer. I'm surprised it hasn't been shut down yet. Blue Cross has plenty of mechanisms to identify this kind of stuff.

 

Except when the samples are coming from outside the area that needs critical access. If you are sending samples from Pittsburgh to a hospital in say Beckley, WV then the waiving of co-pays and deductibles will not apply. This scheme is just to get around the OON status of other labs and bill insurances like UPMC. This is a massive fraud!

 

That is Sam Kabbani and Shilela's lab?

 

Vitas already is under audit by the payers

 

Mission and Sun are being sued by United Healthcare