Home E-Weekly January 30, 2018

Suit: Insurer Reimbursed Patients, Not Hospital Says Insurance Co. Failed to Reimburse Them $400k

Published: January 30, 2018

REIMBURSED St. Charles Surgical Hospital says Blue Cross/Blue Shield owes them after failing to reimburse them for multiple patients' procedures.

A surgical hospital that specializes in breast reconstruction is suing Blue Cross/Blue Shield of Louisiana for breach of contract, claiming the insurer reimbursed patients and not the hospital more than $400,000, court records show.

St. Charles Surgical Hospital in New Orleans, La., filed the suit last month, claiming Blue Cross/Blue Shield paid out $411,761.40 to several patients — reimbursements to which the hospital says it was entitled.

The hospital is requesting that the insurance provider pay for damages sustained by the error as well as court costs and attorney fees.

Neither Blue Cross/Blue Shield of Louisiana, nor James Williams, an attorney representing the hospital, responded to requests for comment.

St. Charles Surgical Hospital specializes in reconstructive breast surgery for women facing breast cancer and has been recognized by the American College of Surgeons as one of 37 hospitals participating in the ACS's National Surgical Quality Improvement Program (NSQIP).

Anna Merriman

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