Here are five key insights:
1. Humana filed a complaint against Ameritox on July 28 in the U.S. District Court for the Middle District of North Carolina.
2. Humana alleges Ameritox submitted “false and fraudulent claims” to Humana for urine testing services not covered by the payer’s health plans.
3. According to the suit, the payer hopes to get millions of dollars back that it alleges it overpaid the drug testing company for these invalid claims.
4. Humana also alleges it met with Ameritox earlier in 2016 to explain why they were denying improper claims submitted by the drug testing company. Allegedly, Ameritox continued to bill for “duplicative and medically unnecessary testing,” according to the complaint.
5. Ameritox reported it “disagreed vigorously” with the claims, according to Bloomberg BNA.
More articles on coding, billing & collections:
Facing closures and lawsuits, tension builds over the ACA’s co-ops: 5 takeaways
Improper billing for Medicare payments is still common amongst providers; but is the system to blame? 5 things to know
Escalating drug prices will hurt Medicare’s catastrophic prescription coverage: 5 things to know
