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In-network or out-of-network? Either way, out of business. What’s the solution?

Date: Oct 12 2015
Posted by: admin

Victory Parent Company, LLC

Bankruptcy Filed: 06/12/2015

The solution is: expert and appropriate use of ERISA, HSA, and OIG regulations and guidelines.

No healthcare provider foresees filing bankruptcy. However, it can happen even to some of the biggest names in the industry–as the following case summary shows:

On June 12, 2015, Victory Parent Company, LLC (hereinafter “Victory”) filed for voluntary Chapter 11 Bankruptcy/reorganization in Texas’ Northern District Bankruptcy Court. This came to a shock to medical professionals for three reasons: 1) Victory pretty big (among other things, it manages six (6) for-profit medical and surgical facilities); 2) Victory was established (it’s been around since 2005); 3) Victory had in-network agreements with insurance carriers; and 4) Victory had extremely high quality and state of the art medical centers and hospitals.

Victory operated surgical hospitals, and medical training and education centers. It offered bariatric surgery services; ear, nose, and throat services that included septoplasty, rhinoplasty, submucous resection, sinuscopy, ethmoidectomy, functional endoscopic sinus surgery, turbinectomy, adenoidectomy, tonsillectomy, and ear tube surgery/myringotomy. The company was engaged in the diagnosis and treatment of injuries or abnormalities of muscles, tendons, bones, nerves, skin, and blood vessels in the hand; and provided orthopedic surgery and pain management services. In addition, the company treated a range of ailments, including bunions, corns, flat feet, heel spurs, and hammertoes to Achilles tendon problems, ankle sprains, diabetic feet, and infection; and provided spinal surgery services. Victory’s holding company was founded in 2009 and was based in The Woodlands, Texas with medical centers in Beaumont, Fort Worth, Houston, Hurst, McKinney, Plano, and San Antonio, Texas. It was in joint administration with Victory Medical Center Mid-Cities, LP.

What was the problem? Well, even though Victory entered into in-network agreements with insurance carriers, the insurance carriers were either extremely slow at reimbursing or paying for their healthcare costs–or failed to reimburse or pay at all. The result was a significant constraint on liquidity, a reduction in expenses, and a changing of their facilities to provide fewer and fewer services–all while incurring more and more debt due to the insurers’ lack of reimbursement or payment.

We understand that healthcare providers lead busy lives and that many hours of their days are devoted to serving the people that need them the most. As patient advocates, we appreciate their dedication to public service. We also understand that without sufficient compensation for their services they would not be able to provide the care that their communities have come to depend on. We know that dealing with insurance companies is not always the most pleasant experience. We know this because, as healthcare providers ourselves, we have been in your shoes. Throughout the years we have made our practices easier by developing a streamlined system that gives us consistent results–and we can apply this system to your practice as well.

 


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