Jury Decision Reaffirms ELAP’s Business Model

ELAP Services is pleased to announce the outcome in Centura v. French, where a jury found Centura Hospital’s chargemaster rates for medical services were unreasonable. The jury decision reaffirms ELAP’s successful business model of auditing overinflated and excessive hospital bills, and helping patients and business owners lower the cost of healthcare.

Centura v. French Case Summary
OUTCOME: ELAP’s original audit amount was ruled to be within 98.99% of the reasonable value of the medical care.

In June 2014, Lisa French underwent a surgical procedure. Prior to the procedure in May 2014, Centura Hospital provided an estimate of patient responsibility at $1,336.90. Following the procedure and a three-night stay, the hospital bill ultimately exceeded $300K.

ELAP audited the bill using its metric-based Claims Review & Audit Program to determine a payment of $74,597.35. This amount considered the hospital’s costs of service and allowed a fair profit margin, however, Centura chose to sue the patient for the remaining billed amount ($229,112.13).

The jury decided that the hospital should be awarded just $766.74 more, meaning ELAP’s original audit amount determined the reasonable value of the medical care within 98.99% of the jury’s determination.

“We believe the jury decision shows our payments are fair to healthcare providers and reflect the values of the communities where our members live,” ELAP co-founder and CEO, Steve Kelly, said. “Our commitment to fairness is one reason why ELAP Services has a good working relationship with most providers — we have found that employers and providers can benefit from working together to establish more affordable healthcare.”

For over a decade, ELAP Services has been advocating for business owners and patients to pay reasonable prices for healthcare. The Colorado jury’s ruling affirms ELAP’s successful business model of auditing excessive hospital bills in pursuit of this mission.