Inglewood, Calif.-based Prime Healthcare Services will pay $1.2 million to settle an investigation by state regulators for improperly balance billing HMO patients for services not covered by their insurers, according to a report by the San Francisco Gate.
Prime, which operates 13 hospitals and three medical groups, was being investigated for sending letters to 3,700 HMO patients threatening to send them to collections if they did not pay the remainder of charges not covered by insurance. Under the HMO model, patients are only responsible for co-pays, according to the report.
Prime did not admit fault as part of the settlement but will be required to audit six years of records and provide refunds with interest to any patients who paid the balance bills, according to the report. The settlement will go to Prime's charity foundation and six clinics.
Read the San Francisco Gate's report on the Prime Healthcare Services' settlement.
Prime, which operates 13 hospitals and three medical groups, was being investigated for sending letters to 3,700 HMO patients threatening to send them to collections if they did not pay the remainder of charges not covered by insurance. Under the HMO model, patients are only responsible for co-pays, according to the report.
Prime did not admit fault as part of the settlement but will be required to audit six years of records and provide refunds with interest to any patients who paid the balance bills, according to the report. The settlement will go to Prime's charity foundation and six clinics.
Read the San Francisco Gate's report on the Prime Healthcare Services' settlement.