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  2. O.C. judge tied to healthcare fraud scheme with convicted ...

    www.aol.com/news/o-c-judge-tied-healthcare...

    But Do’s plea agreement and the charges filed against him detail how he operated the scheme with “co-conspirator #1,” described as an O.C. prosecutor who in 2022 became a judge, and who ...

  3. Medical billing - Wikipedia

    en.wikipedia.org/wiki/Medical_billing

    Medical billing, a payment process in the United States healthcare system, is the process of reviewing a patient's medical records and using information about their diagnoses and procedures to determine which services are billable and to whom they are billed.

  4. Prime Healthcare Services - Wikipedia

    en.wikipedia.org/wiki/Prime_Healthcare_Services

    In 2008 the State of California and Kaiser Permanente each sued Prime Healthcare over its balance billing practices and Kaiser obtained an injunction preventing Prime from continuing the practice; Prime had cancelled agreements with insurance companies when it acquired hospitals, leaving patients in an out-of-network situation resulting in ...

  5. Healthcare Common Procedure Coding System - Wikipedia

    en.wikipedia.org/wiki/Healthcare_Common...

    The acronym HCPCS originally stood for HCFA Common Procedure Coding System, a medical billing process used by the Centers for Medicare and Medicaid Services (CMS). Prior to 2001, CMS was known as the Health Care Financing Administration (HCFA).

  6. CHMB Inc. - Wikipedia

    en.wikipedia.org/wiki/CHMB_Inc.

    CHMB Inc. is one of the largest California-based companies that provide business services for doctors and physician practices. [1] [2] It was one of the first businesses of its kind. [1] CHMB is an acronym that means California Healthcare Medical Billing. [3] CHMB Inc. is based in San Diego and was founded in 1995 by CEO Bob Svendsen and ...

  7. Capitation (healthcare) - Wikipedia

    en.wikipedia.org/wiki/Capitation_(healthcare)

    HMOs and insurers manage their costs better than risk-assuming healthcare providers and cannot make risk-adjusted capitation payments without sacrificing profitability. Risk-transferring entities will enter into such agreements only if they can maintain the levels of profits they achieve by retaining risks. [4] [6]

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