In the case of United States ex rel. Geraldine Petrowskivs. vs Epic System Corporation, Geraldine Petrowski worked as a the Supervisor of Physician’s Coding at WakeMed Health from 2008 until 2015. She was then trained to be a charge capture analyst for Epic’s billing charge capture system. After that she went on to work as a hospital liasion for the implemention of Epic at WakeMed Health. In 2015 Petrowski alleged that a glitch in Epic’s billing system had caused hundreds of millions of dollars in overbilling. Soon after, Petrowski filed a lawsuit with Florida’s U.S district. In the complaint Petrowski wrote “ Epic’s billing software defaults to charging for both the applicable base units for anesthesia provided on a procedure, as well as …show more content…
Epic had moved to have Petrowski’s lawsuit dismissed entirely stating she failed to prove fraud under the Federal Rule of Civil procedure 9(b). The Federal Rule of Civil procedure states that in alleging fraud or mistake the party must state with particularity the circumstances consituting fraud or mistake. Malice, intent, knowledge and other conditions of a persons mind may be generally alleged. Under Federal Rule of Civil Procedure 12(b)(6) allows a complaint to be dismissed for failure to state upon which relief can be granted. When reviewing a motion to dismiss, courts must accept all factual allegations in the complaint as true and review the facts in a manner that is favorable to the plantiff. One way to statisfy the criteria is to provide details of specific billing information, such as dates, amounts of actual claims. The lawsuit states that Petroski was unable to provide any of those details or a copy of any …show more content…
Petrowski’s lawsuit had to deal with the aspect of Epic’s medical records software that lets hospitals choose how they itemize bills for anesthesia. The anesthesia payment system for Medicare and other payors is based on the American Society of Anesthesiologists' Relative Value Guide. This system includes the base units and how to recognize preoperative and postoperative work as well as
Edmond’s was a suspect fraud investigator that worked for Discover credit card. He called to report his company flagged some purchases made on a Discover credit card with the cardholder being James Frank Boucher. Edmond was aware James Frank Boucher was issued a second Discover credit card due to previously reported fraud activity on the previous account. Discover contacted James Frank Boucher via telephone on 09/03/2016 at 1100 hours. Discover questioned James Frank Boucher about 3 transactions made on 09/02/2016. James Frank Boucher denied using his credit card for the 3 transactions. All 3 transactions were committed on 09/02/2016. 1) Circle K located at 111 E. Walnut St. Murphysboro, Illinois in the amount of $8.64 at 1241 hours. 2) Wal-Mart located at 6495 Country Club Rd. Murphysboro, Illinois in the amount of $73.40 at 0104 hours. 3) Walgreens located at 503 Walnut St. Murphysboro, Illinois in the amount of $1.94 at 0952 hours. The suspect attempted to make a cash advance at Circle K and Walgreens, but was declined. Edmond indicated the reason for the report to the local authorities was due to James Frank Boucher having a second report of fraud and believed it was necessary for the authorities to investigate. Discover reimbursed James Frank Boucher’s account after learning the 3 transactions listed above were fraudulent. I advised Edmond there was a report on file
When conducting research for my project, I came across a website that contained a few primary sources regarding the Salem Witch Trials. One of these primary sources was the photo of a legal document explaining the death warrant and reasons for execution of a woman named Bridget Bishop. Bishop was claimed to be a witch in Salem during the year 1692, and the document explaining her significance involving witchcraft resides in the Peabody Essex Museum in Salem, Massachusetts. My thesis for this primary source is that the judge and jury believed they were seeking justice by executing Bishop, a woman whose death was truthfully based on her differences as a person rather than actual crimes she committed.
Team owner Fay Sollenberger was pleased that the team was recognized at their awards banquet.
The court’s decision based on the treatment of young people in this case emphasizes on the concept of social justice, which means the fair allocation of wealth, resources and opportunity between members in a society. The appellant in this case, Louise Gosselin, was unemployed and under the age of 30. She challenged the Quebec Social Aid Act of 1984 on the basis that it violated section 7 of her security rights, section 15 of her equality rights in the Canadian Charter of Rights and Freedoms and section 45 of the Quebec Charter of Human Rights and Freedoms. For the purpose of this essay, we shall explore the jurisprudence analysis of section 7 and section 15 of the Canadian Charter of Rights and Freedoms. Section 7 states that everyone has the
Milwaukee teacher Katherine Gonzalez had a twisted way of helping her 11-year-old "chronically depressed" student cheer up.
Learning from what Dr. Anna Pou had to face with the lawsuits she was dealing with makes me cringe. As Healthcare professionals, having to worry of possibly being sued for believing what is right for the patient or as a whole for the hospitals health is ridiculous. Healthcare professionals like Dr. Pou, have taken the Hippocratic oath, and one of the promises made within that oath is “first, do no harm”. Often time’s society look at courts cases as a battle versus two oppositions, but Dr. Pou’s case it is not. In her statements from national television she states saying her role was to ‘‘help’’ patients ‘‘through their pain,’’.
113-117. Retrieved April 21st, 2011 from website: http://secure.cihi.ca/cihiweb/products/physicians_payment_aib_2010_f.pdf. D. Squires, The Commonwealth Fund, and others, International Profiles of Health Care Systems, The Commonwealth Fund, June 2010. Retrieved April 20th, 2011 from website: http://www.commonwealthfund.org//media/Files/Publications/Fund%20Report/2010/Jun/1417_Squires_Intl_Profiles_622.pdf. Johns, M. L. & Co. (2010). The 'Standard' of the 'Standard'.
On 08/05/2016 at approximately 1:50 AM, this Investigator with Investigator V. Shroyer arrived at 12211 N. Paradise Village Parkway, Phoenix, AZ for Case # 537001 report of Child Neglect for victim Fiona McFadden (DOB: 03-05-2013) against her mother Monica Katich (DOB: 09-17-89). Upon arriving on the scene, this Investigator met with the report source, Phoenix Police Officer E. Gomez # 7977 in reference to Phoenix Police DR: 2016-00001441605. According to Officer Gomez, Phoenix Police received an emergency 911 call from Monica Katich that her friend later identified as Ashley Brook Post (DOB: 06-21-83) had overdosed on Heroin. Upon Officer Gomez arriving on the scene, Monica told Officers Gomez and Officer Cambell (#9021) that her friend Ashley
This case involves the suspect hitting the victim in the face with a plastic broom. The victim did not sustain any injuries.
Carla Washburn, an incredible, inspirational woman that has sadly witnessed the 3 closest male figures in her life all pass on. This has resulted in Carla becoming depressed over the unbearable experience. Carla embraced in giving back to the community and that’s not surprising because she’s a person of spirituality. While, Carla is the client and is suffering through grief, it’s likely she’d benefit immensely from creating a program to work with the kids in the community and may give her a sense of worth she’s been seeking since these 3 tragedies.
Rockwell, P.E.,M.D. Director of Anesthesiology, Leonard Hospital, Troy, NY, U.S. Supreme Court, Markle vs. Abele, 72-56, 72-730, 1972. P.11
In the past Parallon has had limited opportunities for en masse analysis. Requirements for analysis include unit number, patient number, client information, payor and payment information, and general logic. Improving Parallon’s accounts receivable process required a standardized analysis process. Accounts eligible for analysis do not have Medicare as a primary insurance, and secondary was present. All accounts must be in accounts receivable or collections agency status. Organizing accounts into three specific categories assisted in developing decisions based on account criteria. Account separation methods included accounts without a primary or secondary payment processing, accounts above threshold, and accounts with a denial code. Conflicting processes result in the inability to review denial accounts through this standardized process. Placing thresholds on financial classes limits the amount of errors possible due to contract agreements and rates. Payment percentages determine if accounts meet payment threshold requirements for analysis.
Queen's Printer, V. B. (2014, October 12). British Columbia Healthcare Services, Canada. Retrieved from http://www.bclaws.ca: http://www.bclaws.ca/civix/document/id/complete/statreg/96070_01
I interviewed Vanessa LaSalle who is very funny and ambitious as well as a very energetic person. Vanessa and her family moved from Chicago to Springfield seven years ago, she is married and has three children, Vanessa has ambitious goals for herself and her children that’s why she came back to school to achieve her goal, by asking her about her life goals Vanessa answered that she is looking forward to getting a degree in business and be a successful woman, that’s why she came to Lincoln land and started taking general classes, when I interviewed Mrs. LaSalle she said that she has a fascination in business. In the morning Mrs. LaSalle enjoyed her pecans and egg sandwiches for breakfast, Vanessa go to church in her free time, Vanessa think
Issue: The appellants are claiming that the court erred in determining that the Medical Liability and Insurance Improvement Act (MLIA) was not applicable in their claims. Mainly on errors and omissions of medical staff as well as asserted administrative negligence of the hospital that actually occurred before the defendant was admitted at the facility. The appellees’ motion relied on Rose v Garland County Hospital. (Las Colinas Medical Centre)