After Congress officially outlawed surprise medical bills last year, there’s been endless, litigious debate as to how health insurance companies and providers should settle their differences over how much to pay for out-of-network medical bills. Now, an air ambulance provider that already went through the arbitration process is suing Blue Cross Blue Shield of Arizona, which the company says won’t pay the agreed-upon amounts.
The idea behind the arbitration process is to protect patients from getting slapped with massive bills when providers and insurers can’t agree on how much a given health care service is worth. Instead of billing patients for the difference, the government established an independent dispute resolution process in which a third party picks between the provider’s and the payer’s offers for a claim.
This case is one of the first where the provider isn’t disputing the arbitration process itself, or the amount chosen. Instead, the air ambulance company, PHI Health, says BCBS of Arizona has failed to pay up after arbitration — even in cases where the arbitrator chose the amount the insurance company proposed.
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