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Did the SynerMed closing affect your medical practice?

Earlier this year, information provided by a whistleblower led to the downfall of SynerMed, one of the nation's largest Management Service Organizations (MSOs). SynerMed and its parent company Pacific Alliance Medical Center both closed their doors effective November 30.

Wrongfully denied claims for thousands of patients

The 20-page report submitted by an executive of SynerMed revealed years of systematic denials and cover-ups of incorrectly handled medical claims. The ensuing investigation by California regulators and health officials confirmed the allegations.

With over 1 million enrollees in California, SynerMed managed medical care and services for Medicaid, Medicare and commercially insured patients. Those receiving Medicaid benefits were hit hardest by the wrongfully denied claims.

The effect on California medical providers

Medical professionals who had contracts with SynerMed were also adversely affected. The MSO handled financial and business operations for numerous medical providers in the state, facilitating services between the providers and health insurance companies. Each independent doctor, physicians group and medical practice under contract with SynerMed had to scramble to find a new management company.

Establishing a contract with a MSO

As a practicing physician, your skill set may be vastly different from those needed to manage a medical practice and wade through the myriad rules and regulations required by state and federal agencies.

Identifying and contracting with a MSO can be a daunting task as well, especially when you are forced to do so quickly. You must find a company that will ensure your compliance with state and federal regulations without stepping over the line into the practice of medicine.

Before signing on the dotted line for a contract with a new MSO, thoroughly check its credentials, understand of the provisions of the contact you are signing and make sure that the structure of your business provides you with the highest level of protection should something go wrong.

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This is an advertisement for legal services.
The information you obtain at this site is not, nor is it intended to be, legal advice. You should consult an attorney for advice regarding your individual situation. Contacting us does not create an attorney-client relationship. Please do not send any confidential information to us until such time as an attorney-client relationship has been established.

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