Aetna Files $20M Lawsuit Against California ASC Company for Alleged Overbilling

Insurance company Aetna has filed a $20 million lawsuit against a Northern California surgery center firm, claiming the company is overbilling the payor, according to a Sacramento Bee report.

Advertisement

The lawsuit, filed in Santa Clara County, claims Bay Area Surgical Management recruited physicians to invest in its seven outpatient facilities in a scheme to help physicians profit by sidestepping state laws. The payor alleges the surgery center firm overbilled Aetna, billing $66,100 for a bunion repair, $6,642 for a colonoscopy and $23,301 for a knee arthroscopy.

Bay Area Surgical Management denies Aetna’s allegations and says the insurance company is using the lawsuit to strong-arm patients away from its facilities.

Related Articles on Coding, Billing and Collections:
ASC Quality Reporting Secondary Payor Issue Resolved
Consumer Reports: Healthcare Prices Vary Drastically Between States, Cities, Physicians
Healthcare Spending Growth Expected to Rise 7.5% in 2013

At the Becker’s 32nd Annual Meeting: The Business and Operations of ASCs, taking place October 29-31 in Chicago, ASC leaders, surgeons and healthcare executives will explore strategies to drive growth, enhance operational performance, navigate reimbursement challenges and prepare for the future of ambulatory surgery. Apply for complimentary registration now.

Register to Attend Webinar

Is ambulatory care healthcare’s big margin engine? 4 leaders weigh in

Wednesday, July 29
1:00 PM - 2:00 PM CDT

Presenters: Joe Ganley, athenahealthJeffrey Flynn, CASC, Gramercy Surgery CenterBryan Tsao, Access Center, Loma Linda University HealthJason Zepeda, Northridge Hospital Medical Center, CommonSpirit HealthGreg DeConciliis, PA-C, CASC, Boston Out­Patient Surgical Suites

Advertisement

Next Up in ASC Coding, Billing & Collections

Advertisement

Comments are closed.