Doctors: Starting to Figure it Out?

David Mittleman

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It’s not the trial lawyers they have to fear and hate - it’s the insurance industry. A pediatrician has filed a federal class-action lawsuit against Hometown Health Plan and Renown Health, claiming they bilked thousands of Nevada doctors out of tens of millions of dollars by failing to pay claims, manipulating payment codes, and forcing the doctors into one-sided contracts.

Dr. Kevin Windisch of Sparks Pediatric & Adolescent Medicine says, "Those behaviors drive doctors out of business, and other doctors won’t come to this community because of it." According to Dr. Windisch, the loss of good doctors ultimately hurts the patients, some of whom may lose longtime family physicians because of the insurance companies’ behavior.

In addition to seeking compensatory and punitive damages, the suit asks the court for an injunction preventing the companies from engaging in these improper practices that adversely affect the doctors and their patients.

Recently,UnitedHealthcare agreed to pay $350 million in a settlement between the company and 40 states. UnitedHealth is the biggest U.S. health insurer. The payment is as a result of the healthcare giant defrauding its members by underpaying and manipulating reimbursements made to doctors and patients. Under the terms of the agreement, UnitedHealth has agreed to set up an independent database to reduce the likelihood of a repeat offense.

If you or someone you know has been a victim of insurance abuse, contact us. Our firm has been fighting insurance companies for over 50 years. Know your rights, let us protect them.