S.F. Community Health Authority Fined $30K by DMHC
The California Department of Managed Health Care has fined the San Francisco Community Health Authority over the mishandling of payments for provider claims. The $30,000 fine was issued after a routine audit in 2012 found a programming error in a new claims system. The agency later found that SFCHA's plan to address the error failed to provide information on why claims were adjusted or denied in 8% of cases examined. In addition, the agency found that SFCHA failed to properly settle disputed claims in 20% of cases.
- "DMHC Fines SF Health Plan $30,000" (Shinkman, Payers & Providers, 10/22).