BLOOD MONEY - The Most Impossible Book To Obtain Just Landed In My Lap!

The Chris Riedel Story - 2011 Whistleblower of the year

I tried everywhere to get this book until I reached out to the author, my old boss Chris Riedel.

The powers that be don’t want this book out! Makes sense, Qui-tam and false claims would seem to be all the rage considering what the world has been through for the last five years especially.

Chris is one of my ace cards I’ve been holding in my back pocket for a long time. I’ve pretty much been out of touch with the Riedel family since at least 2015 after this case and selling his laboratory to Bio-Reference labs. The last year of my employment with Hunter labs was technically under the control of Bio-Reference and it took that long to gut the billing department and migrate data, task and responsibilities over to their ~200 person billing operation in New Jersey. Interestingly Bio-Reference offered me a great position in NJ as basically one of the two or three top people in the billing department. After I declined mainly because I’m a Bay Area guy with deep roots, they offered me a “Turk” position in California starting in the Southern California L.A. area. You see when Bio-Refence Labs bought Hunter Labs in Campbell, CA it was basically their first entrance into the West Coast or basically anything west of Texas. Hunter was the springboard and they were gobbling up a few more privately owned labs along the west coast. They offered me the position to Rambo into these next labs and help "transition” billing operations back to New Jersey.

Transitioning a billing department requires a lot of tech work but also requires a ton of paper work with insurance companies with name changes, submitter ID# changes with claims clearinghouses, Electronic Funds Transfers (EFT) to the bank, etc.

I spent the last year at Hunter chopping up the pig and handing it over on a silver platter to the billing bosses in New Jersey. It was bitter sweet, but in exchange I had high level access to the entire Bio-Reference medical billing operations. This was a billion dollar lab and considered the #4 largest laboratory in the nation behind Lab-Corp, Quest, and ARUP (Univ of Utah). It should be mentioned that ARUP is the largest “reference” lab meaning other labs could refer their tests to ARUP so ARUP can perform the test because they didn’t have the instruments or machines to run some of these exotic tests.

Anyhow, I have some old screen grabs that I think are past the statute of limitations showing Bio-Reference with Hunter Included, was submitting 12K-23K claims a day for reimbursement but averaging about 18K/day. These are some screen shots through our Emdeon Dashboard:

Maybe I’m naive but I don’t think there is more than 100 people in the USA that has visibility and access to this much data considering there were only a few people at BioReference that had “Master Control” access. All other billing and administrative people had various degrees of visibility, but could not go in and edit master files like fee schedules, NPI numbers, Tax ID# nor make any global edit changes.

I was really privileged back in these days but earned my position and trust running Chris Riedel’s billing operation for ten years or basically the whole life of Hunter minus the very first year. Marcia Riedel, Chris’ wife was officially the billing boss but I was the quarterback running all the plays. God Bless Marcia, she hired me on the spot after my interview with her back in the early days. Game recognize game.

Chris gives Marcia a lot of credit in the book and rightfully so, Marcia is a powerhouse and leader in every respect. It was a good setup “we” created. I actually remember a hiccup that was not mentioned in the book and that was the Mysis Tiger Billing Suite Hunter Labs started off with, before quickly jumping into the more powerful Seacoast Laboratories software (SLAR/SLAB) specifically designed for laboratories. Mysis Tiger was not even in the ballpark, neighborhood, or zip code for what Hunter needed. Mysis Tiger was a good midrange piece of software, good for physician groups but not enterprise level.

I’m only half way through the book but it brings back a lot of fond memories and names I recognize. Since this is a whistleblower case, many in the company had no idea what Chris & Marcia were going through including myself for at least the first half. I do remember news crews showing up at the lab one day after the Qui-tam case was unsealed and the DOJ announced they would intervene.

That was the day then Governor Jerry Brown announced this huge Medi-Cal (Medicaid) fraud was being perpetrated and there is Chris Riedel standing next to him on the podium.

More to follow, just wanted to get this initial blurb out. It would be nice to have RFKjr or people in the MAHA movement reach out and tap Chris Riedel for any insights he may have and would be willing to share. Chris & Marcia are good people, even if they are Democrat which they seem to be? God Bless

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In a nutshell this is what Chris was complaining about, and why he couldn’t compete unless he illegally offered sweetheart deals to doctors and entice them to make Hunter their preferred lab, and why he won his case. On the street it’s called the “Pull through”:

The Blood Brothers gave a sweetheart deal to docs so they could make a buck off their cash pay patients. By law they needed to give the government the same sweetheart deal, but did not. Even though Medicare/Medicaid publish their max reimbursable fee, they considered it over paying if a laboratory is giving a sweetheart deal to someone else like a shady doctor and not the same deal to Medicaid. Many doctors are all to willing to play stupid and pretend this rule does not exist, primarily because they are not the ones that are going to get pinched for the deal. Riedel could not compete, because there wasn’t enough honest doctors that were not enticed by the great deal. Most of Hunters accounts were either honest docs, were not interested in labs as a profit center, or simply preferred Hunter because the Blood Brothers service sucked that bad. In the end it was mostly because the Blood Brother service and turnaround times were so bad that physicians and physician groups were willing to try anybody else. Luckily we were small enough and honest enough to run a tight and efficient operation. On a level playing field we could have been big time! Everybody at every level was top shelf, including myself.

If docs were interested in lab as a profit center, they would need to draw their own blood, prep it, and keep it cold until the lab courier would swing by and pick it up everyday. Drawing blood in-house brings on CLIA and COLA requirements and most doctors don’t want to deal with it or feel it is not worth it unless they get a sweetheart deal from the lab.

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