Is this company trying to extort money from doctors?, Part 2

The May 4, 2009 Tennessean has a story on Health Research Insights.  An excerpt:

Health Research Insights, the Franklin-based company that sent the letter, is riding a wave of interest among self-insured employers intent on examining bills from physicians and other providers for what could be overpayment errors.

For employers including Cookeville, Tenn., trucking company Averitt Inc., which hired HRI, it is all part of a push to control rising health-care costs while fulfilling obligations to ensure that their health plan dollars are spent wisely.

But doctors such as Hill question HRI’s techniques, suggesting that the approach seems to assume wrongdoing took place after studying payment data that doesn’t necessarily take into account all the details of a particular patient’s case.

“You should check the medical records before you accuse somebody of fraudulent billing,” said Hill, who responded two weeks later by providing records to show that his billings were accurate.

Others defend HRI’s practices and say it and other similar companies have a role in making sure health-care dollars are spent appropriately.

I’m pretty sure the “others” who defend HRI’s practices are people who don’t have a problem with physicians and hospitals being targets of intimidation by a company that doesn’t bother to look at medical records — the only way to confirm or deny that even the possibility of fraud or overpayment has occured — if it means more money in their pockets.  This sounds like something the Tennessee Attorney General might look into.

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One Response to “Is this company trying to extort money from doctors?, Part 2”

  1. who is Johnny E., Gore, MD? if a Tennesseean, is he related to ex. V.P Gore?

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