Sunday, 5 February 2012

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Springhill Group Florida:: Living and Care Options
Springhill Group living and care options are available depending on what the residents need and prefer.
Independent Living
The independent accommodations are occupied for those who wish to maintain a significant standard of flexibility, but also value the friendly relationship, the security, recreational facilities, and care that is provided by to them.
The homes are designed to allow residents simple and easy household management encircled by warm and friendly neighbours
Assisted Living
Assisted Living is desirable to people who need a little extra care with their everyday living. You will also find here theflexibility and security of owning your personal space, to have your valuable possessions and things around you.
Resthome Level Care
Resthome level care in a Ryman Village, offers residents the very best in clinical care, while receiving the benefits of living in our warm and welcoming community.
Springhill Care Group : 2012 U.S. Healthcare: UCR or ‘$99,750 Ear Wax Fraud’? Aetna Wants Court to Stop Hospital’s UCR Billing
On Dec 7, 2011, Aetna filed a lawsuit against two PPO surgeons and one out-of-network (OON) hospital, in the District Court, Harris County, Texas. Aetna lawsuit seeks to recover damages and attorneys’ fees and for court temporary injunction to stop the OON hospital’s UCR billing and PPO surgeon’s referrals, alleging breach of contract, conspiracy to overcharge, tortious interference, and common law fraud, including “a bill for $99,750 for the removal of ear wax”. A new 2012 “UCR war” already unfolds in the court. offers private Webinars to examine this court case, its profound impacts on all OON providers, and explore compliant solutions and protections under ERISA and PPACA as well as OIG Guidance.
Aetna OON UCR Case info: AETNA HEALTH INC vs. SOFOLA, IFEOLUMIPO O (MD) (Case #: 2011-73949 / Court 152)
In 2012, most out-of-network (OON) doctors, surgical centers and hospitals will “make it or break it”, depending upon the outcome of this new Aetna lawsuit, as an emerging trend in managed litigations.
“While the alleged $99,750 ear wax UCR fee may or may not be an isolated inadvertent error, the payor’s new lawsuit to outlaw all OON UCR billing as fraud certainly represents a new 2012 trend and detrimental blow to all OON providers and 77% of insured Americans in private industry,” says Dr. Jin Zhou, president of, a national expert on PPACA and ERISA appeals and compliance.
“Failure to recognize the impact of the payor UCR legal actions under $99,750 ear wax anti-fraud strategies and to quickly act with compliant solutions, the OON market will most likely fail by the end of 2012,” warned Dr. Zhou.
According to the court documents, “Plaintiffs Aetna Health Inc. and Aetna Life Insurance Company (collectively, “Aetna”) bring this action under the laws of this state against Defendants Ifeolumipo O. Sofola, M.D. (“Dr. Sofola”), Navin Subramanian, M.D. (“Dr. Subramanian”), and Humble Surgical Hospital, LLC (“HSH LLC”), for breach of contract, unlawful and excessive fees, and to recover damages and reasonable attorneys’ fees for injuries Aetna suffered as a result of the Defendants’ scheme to steer patients to Humble Surgical Hospital (“HSH”), a “non-participating” surgical hospital owned or leased by HSH LLC in which Drs. Sofola and Subramanian through their membership in HSH LLC had a financial interest. HSH in turn sought and received excessive fees from Aetna and its members, charging fees far higher than the reasonable charges for the same services in the relevant market.”

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