Health Insurer Settles Class Action Regarding Reimbursement for Out-of-Network Charges

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In a very interesting case, New Jersey health insurer Horizon Blue Cross Blue Shield has agreed to pay $22 million to settle a class action for failing to pay out-of-network claims for ambulatory care.  For more click here.

My compliments to the doctors who pursued this claim and their lawyers.  Sorting out the extremely complicated formulas, rate manuals, and regulations associated with reimbursement for medical care is no simple task.

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