Doctors and health care providers, like everyone else, want to be paid fairly for the services they provide. For patients with health insurance, one would think the insurance company would pay the doctor an adequate amount. After all, that’s why you pay such a high premium, right?
A Georgia lawsuit is challenging health insurers, specifically Blue Cross Blue Shield of Georgia, to explain why premiums have remained high while payments to doctors have decreased. Blue Cross Blue Shield of Georgia is the state’s largest health insurer, just as Blue Cross Blue Shield of Michigan is the largest insurer in our state.
According to the suit, filed by Georgia’s former Insurance Commissioner, BCBS of Georgia overcharged consumers because it was reducing payments to out-of-network medical providers without also cutting premiums. “Out-of-network” providers are typically more expensive because they are not bound to a contractual payment rate with the insurer like “in-network” providers are.
Blue Cross Blue Shield of Georgia denies any wrongdoing and claims it has fairly compensated all doctors.
recently named in the 2009 edition of Best Lawyer's In America, David Mittleman has been representing seriously injured people since 1985. A partner with Church Wyble PC—a division of Grewal Law PLLC—Mr. Mittleman and his partners focus on medical malpractice, wrongful death, car accidents, slip and falls, nursing home injury, pharmacy/pharmacist negligence and disability claims.