New York Attorney General Eric T. Schneiderman announced an agreement with GHI, a subsidiary of EmblemHealth, on an out-of-network reimbursement issue.
The settlement requires GHI to improve plan disclosures for OON provider benefits for all members who sign up for its Comprehensive Benefits Plan. Additionally, GHI must establish a $3.5 million consumer assistance fund to provide financial aid to members and pay $300,000 in penalties to the Attorney General's office.
"Because GHI failed to adequately disclose its out-of-network benefits, individuals and families across New York City lose out on millions of dollars in reimbursements. Consumers need to have accurate information in order to make informed decisions when selecting their health plans," said Attorney General Schneiderman.
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The settlement requires GHI to improve plan disclosures for OON provider benefits for all members who sign up for its Comprehensive Benefits Plan. Additionally, GHI must establish a $3.5 million consumer assistance fund to provide financial aid to members and pay $300,000 in penalties to the Attorney General's office.
"Because GHI failed to adequately disclose its out-of-network benefits, individuals and families across New York City lose out on millions of dollars in reimbursements. Consumers need to have accurate information in order to make informed decisions when selecting their health plans," said Attorney General Schneiderman.
More articles on coding and billing:
Are bundled payments worth it? An ASC case study
3 tips to rejuvenate ASC, physician practice revenue cycle
3 quick tips to improve ASC billing and collections