NC patients sue insurance company over claims of thousands of dollars in surprise bills
Six Charlotte-area patients claim that their insurance company, UnitedHealth Group, stuck them with unexpectedly large bills after dropping their anesthesiologists out of its network.
The patients, along with Providence Anesthesiology Associates, filed a class-action lawsuit against UnitedHealth Group in Mecklenburg County Superior Court Monday.
Providence, which is now out-of-network for UnitedHealth, is the primary provider of anesthesia services at Novant Health. Novant Health is in-network with UnitedHealth — meaning patients with UnitedHealth insurance plans may find themselves at an in-network facility without an in-network anesthesia service.
But UnitedHealth disputes the lawsuit’s allegations, saying Providence is the one billing patients “exorbitant charges.”
“The fact that Providence has joined a lawsuit focused on the surprise bills that Providence itself has been sending to patients is just the latest example of the extreme lengths to which it will go to protect its egregious billing practices,” UnitedHealth said in a statement Tuesday. “…In the meantime, we will vigorously defend ourselves against the claims in this lawsuit and will continue doing everything we can to protect our members from Providence’s surprise bills.”
One woman who joined the lawsuit, Cynthia Vigdor of Waxhaw, said she tried to work with UnitedHealth before her spinal surgery left her with several thousands dollars in unexpected charges.
Providence notified her that the practice was out-of-network with United before her spinal surgery in July 2020, according to a statement from Raleigh law firm Smith Anderson, which is representing the patients. She said she called United and was told it would be “no problem.”
But Vigdor received a bill for $4,511 after United covered $189 for anesthesia services, according to the law firm.
Providence was in-network with United for 27 years, until February 2020, according to the law firm’s statement.
UnitedHealth had offered Providence a 60% decrease in its reimbursement rate, Providence anesthesiologist Dr. Kevin Crosby told the Observer.
“Our first reply back was: ‘Wait a second, was there a mistake in what you offered?’ “ Crosby said about the negotiations. “Because it was just a little bit egregious.”
Crosby said Providence offered to drop its rates to 2016 levels, but that wasn’t accepted by UnitedHealth.
Both organizations allege the other has not acted in good faith. Providence is suing UnitedHealth for unfair or deceptive trade practices and breach of contract, according to the lawsuit.
UnitedHealth has 30 days to respond to the lawsuit, Smith Anderson attorney Mitch Armbruster told the Observer.
Patients with UnitedHealth plans can find in-network facilities and in-network anesthesiologists at other hospitals in the Charlotte area, including at Atrium Health Anson, Atrium Health Mercy, Atrium Health Pineville, Atrium Health University City, CaroMont Regional Medical Center and others, according to the insurance company.
Novant Health declined to comment on the pending litigation.
Editor’s note: This story was updated on Sept. 2 to correct the spelling of attorney Mitch Armbruster’s name.
This story was originally published August 17, 2021 at 1:26 PM.
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