Pass-Through Billing or Unpaid Claims? Knox County and BCBS Headed to Arbitration

In the dispute between Blue Cross Blue Shield of Texas and the Knox County Hospital District, both parties are claiming wrongful conduct. Knox County says that Richardson-based BCBSTX hasn’t paid millions of dollars in claims, while the insurance giant says the charges are connected to the hospital’s pass-through billing scheme. The case is headed to arbitration after a judge’s ruling ordered both parties to attempt Alternative Dispute Resolution, while staying other portions of the lawsuit. After BCBSTX had perviously filed a motion to have the entire matter sent to arbitration, the U.S. District Court for the Northern District of Texas in… Full Story

Now Open: 72-Bed Eating Recovery Center in Plano

Eating Recovery Center, a new 72-bed behavioral health hospital specializing in the treatment of eating disorders, opened this week. The 100,000 square-foot center in the Plano Legacy area will offer inpatient, residential, partial hospitalization, and intensive outpatient care for children, adolescents, and adults. “For two years, new patients have often needed to wait for an available treatment bed,” said Dr. Stephanie Setliff. “Texans desperately need treatment options here at home, not just for convenience and comfort, but also so they can fully utilize their insurance benefits. This new treatment center more than doubles our capacity to treat those patients in… Full Story

Texas Health Remembers COO Dr. Jeffrey Canose

Texas Health Resources Chief Operating Officer and senior executive vice president Dr. Jeffrey Canose died Friday, Jan. 17 after losing his battle with lymphoma. He was 62. “Jeff was, first and foremost, guided by his deep and abiding faith. He was a servant leader in its truest sense. This foundation, coupled with Jeff’s unwavering conviction in our Mission, fueled his relentless drive for “every, every, every” (focusing every day, on every person in every care venue to deliver safe, reliable care),” writes Texas Health CEO Berclay Berdan. Canose joined THR in 2006 as COO of Texas Health Presbyterian Hospital Dallas, and… Full Story

Trump Wants Hospitals’ Negotiated Rates Posted – North Texas Experts Weigh In

The Health and Human Services Department released two rules in November that give clarity on an executive order released earlier last year from the Trump administration about improving transparency in the healthcare industry. But will the rules improve transparency, or add more confusion? And are there already tools in place that accomplish similar goals? The rules say that health insurers must give patients “an estimate of their cost-sharing liability for all covered healthcare items and services, through an online tool that most group health plans and health insurance issuers would be required to make available to all of their members,” which… Full Story

Children’s Health Announces Strategic Alliance with Privia Health

Children’s Health has formed a strategic alliance with population health management firm Privia Health, connecting the pediatric health system’s network of independent physicians to Privia’s services. “I’m thrilled that our alliance creates new opportunities to align with local pediatricians who are delivering high-quality care to children and families,” says Shawn Morris, CEO, Privia Health via release. “Our physician-led model enables providers and health systems to build healthier communities by allowing physicians to focus on what matters most: caring for their patients.” The independent physicians associated with Children’s Health, known as Pediatric Partners, will join Privia Medical Group North Texas to… Full Story

Texas Health Huguley Names New CEO

Penny Johnson will be the new President and CEO for the Texas Health Huguley Hospital Fort Worth South and AdventHealth’s Southwest Region. The hospital is a joint venture between AdventHealth and Texas Health Resources, and the Southwest Region includes hospitals in central and North Texas. Johnson is currently the senior vice president of finance at AdventHealth, where she oversees finance, accounting, treasury, strategic investments, supply chain and more from the corporate office. She began working for AdventHealth in 2002 and has been in leadership at several AdventHealth facilities, including vice president and controller for AdventHealth Shawnee Mission in Kansas, chief financial officer for… Full Story

Holmes Murphy Adds Local Leaders to Executive Committee, Board of Managers

Insurance brokerage Holmes Murphy is adding leaders to its Board of Managers and Executive Committee and is including three local voices. Dallas-based Senior Vice President of Employee Benefits Brad Bierman is a new member of the Board of Managers after serving at Holmes Murphy since 2002. “I am honored to join a group of like-minded leaders driven by operating excellence and a fierce belief in the power of independence and employee ownership,” said Bierman via release. The executive committee is adding two local leaders, including Wally Gomaa, CEO of ACAP HealthWorks and Charisse McCumber, Senior Vice President of Employee Benefits. Gomaa has been… Full Story

Simulation Drastically Improves Trauma Response Times, Study Shows

A new study from UT Southwestern shows how simulations can positively impact lifesaving trauma interventions. The medical center is home to one of the largest medical simulation training centers in the country, which provides a space for instructors to challenge the decision-making and performance of practitioners in high-pressure situations. The study showed how response times for resuscitative thoracotomies, which involve opening the chest cavities of patients without a pulse, improved from 14 to three minutes. Response times for tube thoracostomies, which release the pressure of blood filling the chest cavity, also improved from 13 to six minutes. “What we found most… Full Story

Judge Says Cook Children’s Can Remove Baby From Life Support

After a judge had previously prevented Cook Children’s Hospital in Fort Worth from removing a child from life support, a different judge has sided with the hospital, which says the 11-month old girl is in pain and her condition won’t improve, according to the Dallas Morning News. The mother of the girl, Trinity Lewis, asked Judge Sandee Bryan Marion to make sure Cook Children’s didn’t end the life-saving treatment her daughter Tinslee was receiving. Doctor’s had initially planned on removing her from life support on Nov. 10, when the hospital had been unable to find a facility willing to take… Full Story

The Doctor You See When Nothing Else Works

Last fall, D Magazine profiled UT Southwestern’s Dr. Juan Pascual, the Spanish-born neurologist who is a physician of last resort for patients all over the world when they run out of answers about their brain condition. Pascual’s unique and innovative outlook on treating brain disease has led to a committed patient base and numerous accolades in his work running UT Southwestern’s Rare Brain Disorder Program. Several things set him apart. First is his love of philosophy and respect for the power of language. Especially with brain disorders, he knows that a patient’s emotional state and psychology can be just as… Full Story