In-Depth Information

A rapidly growing body of information exists around healthcare FINANCIAL valuations. Selections are summarized below and direct links, when available, are provided in the sidebar to the right. The developing list will include articles, presentations, citations, references, web pages and other resources related to healthcare charging, pricing, contracting, payments, billing, collections and valuations.

“Valuing Medical Services at 100% of Full Charges – Adding Cash and “In-Kind” Contracted Values,” author: L. Lievense, , Forum Magazine, April, 2007, Monthly publication of Consumer Attorneys of California (CAOC). Discusses in Questions/Answer format how the value of medical services is established from gross charges versus cash payment from healthcare insurances. Full article in sidebar.

“Maximizing Medical Expenses Requires Accurate Valuations,” author: L. Lievense; Santa Barbara Lawyer, October, 2007; Pub: Official Publication of the Santa Barbara County Bar Association. Short article touches on Usual/customary valuations, Hanif, uninsured patient’s charges and valuation of foreign-delivered medical care. Full article in sidebar.

“Urban Myths in Healthcare Finance,” Notes on presentation by L. Lievense to a major San Francisco law firm, August, 2007. Discussion topics use “challenge” type questions to discuss beliefs commonly misunderstood in the general public and some legal arenas, including: Hospitals charge patients different based on payment source (false); Uninsured patients are charged more than insured patients (false); Insurance companies negotiate discounts and pay less (false); Hospital charges are ‘hidden’ and not public (false); The value of medical care equals payment made by insurance (false). Contact L. Lievense, 805-389-1750 for details or to schedule the presentation.

“Katiuzhinsky v. Perry,” dated 6/29/2007; C050376 (Super CT # 02AS07690. Sacramento appellate decision which includes statements on introduction of full charges as reasonable and not as an inappropriate windfall to plaintiff. Also lists three in-kind payment benefits which hospital receives from lender as reason to reduce the cash payment for a lien. Specifically: The provider obtains: (1) immediate payment and (2) transfers the expense of collection and (3) the risk of nonpayment onto someone else.

“http://www.oshpd.state.ca.us” Site of California’s ‘Office of Statewide Health Planning and Development (OSHPD), healthcare Qualify & Analysis Division which show the chargemasters of California hospitals. Chargemasters (CDM) contains the prices of all services, goods, and procedures for which a separate charge exists. It is used to generate a patient’s bill.