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UHC under federal investigation for Medicare Fraud

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  #31  
Old 07-26-2025, 02:31 PM
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[QUOTE=Cliff Fr;2448695]
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Originally Posted by golfing eagles View Post
Unless the plan was to eventually sell right from the beginning in 2012. Negotiations for a sale began BEFORE the discovery of the mistake in billing[/QUOTE

Big question is did Villages Healthcare already know about
the billing error? I don't think they did.
To my knowledge, neither TVH nor their outside auditors knew
  #32  
Old 07-26-2025, 02:33 PM
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Originally Posted by daniel200 View Post
Lol, you mean before the public discovered the billing irregularities.
"The public" didn't discover anything. Humana, doing their due diligence in acquisition negotiations disagreed with the method TVH was using to bill, which had been approved by a different outside auditor. This triggered reporting to CMS
  #33  
Old 07-26-2025, 02:34 PM
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Originally Posted by CoachKandSportsguy View Post
so then a dentist office would only have about 10 codes or so that they would ever use, so that coding mistakes should be minimal, unless the particular payee contractual rate is very low, such that a coding error which is more profitable is used to probe which patients are more knowledgable or payment sensitive than others. . then a dentist caught by a customer can always blame the cheap labor for coding. . everyone has plausible deniability for errors, no?

seems stacked against the average busy person who just pays bills. .

time for dental codes to be shared here on TOTV by dental service provider per plan. . .
there is power in numbers
You should Google your CPT codes listed on your medical and dental EOB's to see if they match up to what treatment you received and your diagnosis code(s). It doesn't take that long.
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