Narconon Insurance Billing (was Re: Narconon on WSB TV news)

[ethercat]

Maybe they post the number on their sites as med pro is the biller for them?  I dont know but it sure as hell looks fishy to me.  Is this a standard practice?

Looks fishy to me too.  When I put my dentist's phone number in google along with HIPAA, he's all that turns up, and he has his numbers in the hippaspace.com site correctly.  I might try some other doctors' numbers though, because I think my dentist does his own billing.

Look at Section 2 in this:
http://www.hipaaspace.com/Medical_Billing/Coding/National_Provider_Identifier/Codes/NPI_1730339771.pdf

From (same info as above, but on a page):
http://www.hipaaspace.com/Medical_Billing/Coding/National_Provider_Identifier/Codes/NPI_1730339771.txt

Provider Name (Legal Business Name)    :    NARCONON OF OKLAHOMA, INC
      
Provider Business Mailing Address       
First Line    :    HC 67 BOX 5
Second Line    :    
City    :    CANADIAN
State    :    OK
Zip    :    74425-9700
Country    :    US
Telephone Number    :    954-587-7771
Fax Number    :    954-587-8622
      
Provider Business Practice Location Address       
First Line    :    HC 67 BOX 5
Second Line    :    
City    :    CANADIAN
State    :    OK
Zip    :    74425-9700
Country    :    US
Telephone Number    :    954-587-7771
Fax Number    :    954-587-8622
      
Authorized Official       
Title or Position    :    MEDICAL DIRECTOR
Name    :    DR. GERALD D WOOTAN
Credential    :    MD
Telephone Number    :    954-587-7771
      
Provider Enumeration Date    :    09/26/2008
Last Update Date    :    09/26/2008
Detailed Information
NPI Number 1730339771 has the “Organization” type of ownership and has been registered to the following primary business legal name (which is a provider name or healthcare organization name) — NARCONON OF OKLAHOMA, INC .
The enumeration date of this NPI Number is 09/26/2008.
NPI Numer information was last updated at 09/26/2008.

Provider's other registered legal business name is NARCONON ARROWHEAD .

The provider is physically located (Business Practice Location) at:

    HC 67 BOX 5
    CANADIAN , OK
    74425-9700
    US

The provider can be reached at his practice location using the following numbers:

    Phone 954-587-7771
    Fax 954-587-8622

The provider's official mailing address is:

    HC 67 BOX 5
    CANADIAN , OK
    74425-9700
    US

The contact numbers associated with the mailing address are:

    Phone 954-587-7771
    Fax 954-587-8622

The authorized official registered with the “1730339771” NPI Number is DR. GERALD D WOOTAN .

The authorized official title (position) is MEDICAL DIRECTOR.

You can reach the authorized official at the following phone number 954-587-7771.

[ethercat]

I think it's showing us who Med Pro bills for!   Combine that phone number with the word "rehab".

Here's what the NPI (National Provider Identifier) is:
http://en.wikipedia.org/wiki/National_Provider_Identifier

[ethercat]

The NPI numbers are actually provided by a government agency and pulled into hipaaspace.com from there.

https://nppes.cms.hhs.gov/NPPES/StaticForward.do?forward=static.instructions

Penalties for Falsifying Information on the NPI Application / Update Form:
18 U.S.C. 1001 authorizes criminal penalties against an individual who in any matter within the jurisdiction of any department or agency of the United States knowingly or willfully falsifies, conceals, or covers up by any trick, scheme or device a material fact, or makes any false, fictitious or fraudulent statements or representations, or makes any false writing or document knowing the same to contain any false, fictitious or fraudulent statement or entry. Individual offenders are subject to fines of up to $250,000 and imprisonment for up to five years. Offenders that are organizations are subject to fines of up to $500,000. 18 U.S.C. 3571(d) also authorizes fines of up to twice the gross gain derived by the offender if it is greater than the amount specifically authorized by the sentencing statute.

[BMF]

Maybe they are creating these third party companies so they can have a third party bill for "out-patient" services so they get paid.  Insurance companies typically dont want to pay for inpatient rehab.

[ethercat]

The way Narconon of Georgia was doing it, in Narconon's name with the payments going to NN, it would have looked like Drs. Locarnini and Robbins were staff doctors at NN.¹ 

However, different (unrelated) doctors will naturally have different billing companies.  If an insurance company was getting bills from several doctors at an outpatient facility, it could look suspicious.  But using different doctors, with different billing companies, it could look to an insurance company like these were outside doctor visits for things other than rehab-related.


¹ Plus, Mary R. was a ditz, and I wonder if she didn't bill the one time using Dr. Robbins' name as revenge, because of something related to the Desmond case.  It was odd timing to bill with her name, since Robbins allegedly had not worked with them for 5? years.)

[10oriocookies]

Mary is an idiot and she deserves what she gets.  I hope her sentence is the maximum allowed by law.  A message needs to be sent to these guys.  Shape up or ship out.  Get in line with standard practices in the rehab field or fold up.  Im fucking disgusted by the loss of life at AH and GA.  It just doesnt have to happen.

Dont even get me started on the scam in Michigan.

[DisconnectedTwin]

Please do start! The more we know, the more effective we are.

[Mary_McConnell]

I think it's showing us who Med Pro bills for!   Combine that phone number with the word "rehab".

Here's what the NPI (National Provider Identifier) is:
http://en.wikipedia.org/wiki/National_Provider_Identifier

What phone number ?

[Witnessman]

Mary is an idiot and she deserves what she gets.  I hope her sentence is the maximum allowed by law.  A message needs to be sent to these guys.  Shape up or ship out.  Get in line with standard practices in the rehab field or fold up.  Im fucking disgusted by the loss of life at AH and GA.  It just doesnt have to happen.

Dont even get me started on the scam in Michigan.

Totally agree about Mary and your sentiments in general.

But whenever you are actually ready to get started on the scam in Michigan, this is the place.  Especially so since (notwithstanding the current absurdities of the state government there) people in Michigan do still have some basic legal rights.

[Witnessman]

Mary is an idiot and she deserves what she gets.  I hope her sentence is the maximum allowed by law.  A message needs to be sent to these guys.  Shape up or ship out.  Get in line with standard practices in the rehab field or fold up.  Im fucking disgusted by the loss of life at AH and GA.  It just doesnt have to happen.

Dont even get me started on the scam in Michigan.

Totally agree about Mary and your sentiments in general.

However, whenever you are actually go and ready to get started on the scam in Michigan, this is most definitely the place.  Especially so since (notwithstanding the current absurdities of the state government there) people in Michigan still do have some basic legal rights.

[Mary_McConnell]

Thanks, Witnessman!

[ethercat]

I'm going to toss in some links I ran across that relate to insurance fraud, just to add perspective outside of Narconon and also some background information for lurkers who may not be up to speed on the intricacies of insurance fraud enough to follow the discussion here:

Insurance Fraud and Abuse: A Very Serious Problem by Stephen Barrett, M.D. of QuackWatch.org

Cracking the Codes - A series of articles focused on how medical billing codes can and are being abused, by the Center for Public Integrity.

[ethercat]

I think it's showing us who Med Pro bills for!   Combine that phone number with the word "rehab".

Here's what the NPI (National Provider Identifier) is:
http://en.wikipedia.org/wiki/National_Provider_Identifier

What phone number ?

954-587-7111

See who me?'s post here, and the few that follow:
http://forum.reachingforthetippingpoint.net/index.php/topic,12245.msg29359.html#msg29359

[ethercat]

Please do start! The more we know, the more effective we are.

Ditto!

[10oriocookies]

Please do start! The more we know, the more effective we are.

Ditto!

I started . Just gathering up some info.

[10oriocookies]

Those trapped in addiction stand to benefit from increased access to help

Under U.S. health insurance reform U.S. citizens have parity in coverage of medical and behavioral health conditions.  “This is good news for millions of chemical-dependent people,” says Bobby Wiggins the Director of Drug Prevention for Narconon International.
 
There are three significant areas affected by insurance reform. Previously uninsured individuals with addiction as a pre-existing condition are now eligible to be insured. College children are included in their parents’ plans with the increase of the cut off age for coverage raised to 26. Health insurance plans that will become available through State Health Insurance Exchanges in 2014 must include  substance abuse benefits. Further, insurance plans are barred from requiring higher levels of cost sharing or imposing more stringent benefit limitations for substance abuse treatment.
 
The 2011 National Survey of Substance Abuse Treatment Services (N-SSATS ) Report, released earlier this month, shows that insurance reforms could lead to immediate and significant change in how Americans deal with substance abuse.
 
13,688 substance abuse treatment facilities participated in the N-SSATS survey. Excluding 539 (4%) facilities that provide free substance abuse treatment, 65 percent reported that they can and do accept private health insurance now. “What insurance reform means for Narconon® facilities is that we will be able to reach many more people who need help,” says Wiggins. “Certainly, we will continue our primary efforts to prevent addiction, but substance abuse remains a problem of epidemic proportion. Handling those already addicted is an immediate concern.”
 
Efforts within the rehabilitation field over the last several years to set up to accept health insurance as a means of payment are likely to pay off based on the findings of the survey. Some key findings that show why are presented here.

Facilities that accept private insurance are more likely to use a sliding fee scale (68 vs. 57 percent) which opens treatment to larger numbers. Facilities that accept private health insurance are more likely than those that do not to have agreements or contracts with managed care organizations (67 vs. 20 percent), a finding that is consistent with the fact that managed care is now the predominant type of private insurance.
 
Facilities that accept private health insurance are more likely to accept adolescents into treatment (58 vs. 33 percent). This is a trend that is expected to continue.
 
Facilities in urban areas are less likely than facilities in non-urban areas to accept private health insurance (75% + vs. 50% +). This can be predicted to change. “Ultimately, these trends mean the salvage of a lot more lives,” said Wiggins. “No one benefits when addicts can’t get the help they need.”

The sure payed off in Georgia hey NN Int.  Per is paying off big time I bet.

[mefree]

Narconon wants insurance .

I imagine managed care contracts will be hard to come by without proper credentials.

[CoolHand]

Look at the 990 forms on Arrowhead.  Their income declined steeply from 2005 til 2008.  They had to figure out a way to bill insurance just to keep the doors open.  At one point they had nearly twice as many staff as they did students (roughly 150 to 80, though most were menial, administrative or promotional staff) and they had to lay off a bunch of "dead weight". 

Then they found MedPro Billing.

It's always been about the money at the top.  Greed.  Program faults aside, the model of having 200+ addicts under one roof for a long-term residential program is begging for disaster.  They cannot be controlled, and other Narconon centers bash Arrowhead on that fact to steal prospective clients from them.  You should see the KR (Knowledge Report) wars over the years between Narconon centers to Narconon Int over who stole who's clients/$.

[10oriocookies]

Luke,

Scientology is always expanding...... They never had a bad year.  Heaven forbid they not be able to get themselves out of a mere decline in revenue considering they have the CONDITIONS FORMULAS.  Stats declining a bit, just start promoting or producing, dont worry about where the money comes from to do it.  Just spend that $10k on google adwords.  You will make it back!

In all seriousness, I found it quite humorous that they put it on their website and are having guys like Per and Mary just milk insurance compaines for everything they possibly can.  Its like, "oh, he breathed 17 quarts of air while in WD, we can bill for oxygen tanks and breathing apparatus.  He needed help breathing so we can bill for out-patient breathing instruction from a local expert in the field, aka Dr Wootan."  BARF.  Im very anxious to hear back from CARF.  Hopefully we dont have to keep this up much longer.


 

[mefree]

Program faults aside, the model of having 200+ addicts under one roof for a long-term residential program is begging for disaster.

Ain't that the truth!