Physician takes tough stance on reimbursement for care.Physician Mark Bell is the Director of Emergency Services emergency services Emergency care '…services …necessary to prevent death or serious impairment of health and, because of the danger to life or health, require the use of the most accessible hospital available and equipped to furnish those services' at Encino Tarzana Regional Medical Center. His position at me hospital has given him an up-close view of the relationship between the cost of medical care and the money that physicians receive for their services from health insurance companies. The hospital does not have a contract with Blue Cross of California because, Bell said, the company has a reputation of poor reimbursement policies. Bell said that because of that, reimbursement of physicians can range from anywhere between 12 and 18 cents on every dollar spent on medical care. "You can get different rates on two different occasions," said Bell. "The cost of business is two or three times what they're paying, which is what gets me upset." "I don't think insurance companies should be making millions of dollars when hospitals are closing," Bell added. Bell, born and raised in Pasadena, graduated from Chicago Medical School The Chicago Medical School is the medical school of the Rosalind Franklin University of Medicine and Science. Founded in 1912, the Chicago Medical School has a nearly 100 year history of a broadly-based socially constructive admission process relatively unlike that of other in 1993 and completed his residency in emergency medicine at UC Irvine Medical Center. Since 1996 he has worked in private practice as a director of emergency medical services An Emergency medical service (abbreviated to initialism "EMS" in many countries) is a service providing out-of-hospital acute care and transport to definitive care, to patients with illnesses and injuries which the patient believes constitutes a medical emergency. at several hospitals, splitting his time between administrative duties and seeing patients. Since bringing his case to the Los Angeles Los Angeles (lôs ăn`jələs, lŏs, ăn`jəlēz'), city (1990 pop. 3,485,398), seat of Los Angeles co., S Calif.; inc. 1850. Superior Court earlier this year, Bell v. Blue Cross has touched off a debate about whether non-contracting physicians can sue health plans for emergency services. During the case, Blue Cross argued that physicians cannot go through the court system, and that only the Department of Managed Health Care can regulate plans. Although the court ruled against Bell, the case was heard in the Second District Court of Appeal in Los Angeles following the ruling. In April, California Medical Association legal counsel Astrid Meghrigian wrote a brief in support of Bell's lawsuit. The DMHC DMHC Department of Managed Health Care (California) also sided with Bell, urging the appeals court to overrule The refusal by a judge to sustain an objection set forth by an attorney during a trial, such as an objection to a particular question posed to a witness. To make void, annul, supersede, or reject through a subsequent decision or action. the lower court. In August, the appeals court overturned the trial court decision, sending the case back to the trial court. Blue Cross officials did not respond to a request from the Business Journal for comment about the suit. Bell, who is waiting for another hearing with the trial court, said he's confident that he will win the case with the support of the DMHC and the appeals court ruling. The Honoree: Physician Advocate Dr. Mark Bell Encino Tarzana Regional Medical Center The Finalists Dr. David Kayne Encino Tarzana Regional Medical Center David Kayne is a former chief of staff at Encino Tarzana Regional Medical Center. Kayne has remained highly respected by the hospital's staff physicians over the years, and has been particularly useful in communicating between hospital staff and management while Encino Tarzana remains for sale by its parent company, Tenet Healthcare Corporation, and unable to embark on improvement and expansion projects. The Finalists Dr. David Takeda Simi Valley Hospital Simi Valley Hospital (SVH) is a Seventh-day Adventist hospital located located in Simi Valley, California. SVH is a member of Adventist Health. New Construction Simi Valley Hospital is in the process of building a new wing to the hospital. Daniel Takeda is a former chief of staff at Simi Valley Hospital, and remains active on staff as well as in volunteering at the Simi Valley free clinic. He has been practicing family medicine in the Simi Valley area since 1986. He graduated from the UCLA UCLA University of California at Los Angeles UCLA University Center for Learning Assistance (Illinois State University) UCLA University of Carrollton, TX and Lower Addison, TX School of Medicine and earned an MBA MBA abbr. Master of Business Administration Noun 1. MBA - a master's degree in business Master in Business, Master in Business Administration in Health Care Executive Management from the University of California The University of California has a combined student body of more than 191,000 students, over 1,340,000 living alumni, and a combined systemwide and campus endowment of just over $7.3 billion (8th largest in the United States). at Irvine. He's been named the California Family Physician of the Year, Best Family Physician and Best Pediatrician in Simi Valley. |
|
||||||||||||||||||||
Printer friendly
Cite/link
Email
Feedback
Reader Opinion