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DPH letter prompts board to seek Blue Shield response on alleged underpayments to ZSFG trauma center
Summary
The Department of Public Health notified Blue Shield of alleged underpayments to Zuckerberg San Francisco General's trauma center; Blue Shield apologized for not acknowledging the May 26 letter, said the matter is with its network-contracting team and cited reasonable-and-customary payment methodology; the board asked Blue Shield to report back to DPH and the board at the next meeting.
Commissioner Sanchez brought a Department of Public Health (DPH) letter dated May 26 that reported substantial underpayments by Blue Shield to Zuckerberg San Francisco General Hospital’s trauma center and asked Blue Shield to respond. DPH said the trauma center’s charges for 2016 totaled roughly $24.5 million for the Blue Shield patients referenced; after processing and what DPH characterized as underpayment, the hospital faced a significant revenue shortfall that could increase the city’s general-fund subsidy.
Paul Brown,…
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