Medical Group Cited For Balance Billing

The Department of Managed Health Care has determined that a Santa Rosa-based medical group broke state law by balance billing patients who received treatment in hospital emergency rooms.

The DMHC concluded that the Chase Dennis Emergency Medical Group balance billed 122 enrollees of the Sistemas Medicos Nacionales health plan, or Simnsa, between early 2009 and recently, likely due to an oversight in the programming of software by its billing agent. No other health plan enrollees were erroneously billed by Chase Dennis, records show.

The California Supreme Court ruled in early 2009 that balance billing of patients treated in a hospital emergency room only was against state law.

As part of a corrective action, Chase Dennis officials agreed to cease and desist the balance billing and refund any payments that had been wrongly corrected.

According to DMHC spokesperson Rodger Butler, only five of the 122 Simnsa enrollees actually paid what they were billed. They were refunded $2,258.27, plus interest of 7% per year for the period Chase Dennis held their money. If they were not located, the money was placed on deposit with the state.

All 122 patients also had their accounts marked as clear by Chase Dennis and its billing agent, Team Health, Inc. According to DHMC records, at least 32 patients had their accounts sent to collection agencies. All collections actions ceased as part of the corrective action, and credit reporting agencies were told to remove any negative information regarded the unpaid balance bills.

The DMHC did not levy a fine against Chase Dennis, which had disputed the accusation made by the agency but agreed to the settlement.