Are you facing surprise medical bills despite having health insurance? You may be a victim of a little-known practice called out-of-network claim repricing, and a company called MultiPlan may be at the center of it.
What is MultiPlan and How Does it Work?
MultiPlan is a data analytics company that helps insurance companies reduce their costs for out-of-network billing and medical care.
While this may sound beneficial on the surface, MultiPlan’s practices often result in patients being unfairly billed for the difference.
Here’s how it works:
- Providers Charge: When you receive care from an out-of-network provider, they bill your insurance company at their usual rates.
- MultiPlan Reduces Payment: MultiPlan uses its proprietary heathcare algorithms to drastically reduce the amount the insurance company pays to the provider.
- Patients Pay the Price: The provider, not receiving full payment from the insurer, then bills you, the patient, for the remaining balance. This can lead to surprise medical bills that can be financially devastating.
The Impact on Patients
- Unexpected Expenses: Patients are left with unexpected and often exorbitant medical bills, even if they have health insurance.
- Delayed or Forgone Care: The fear of high costs may cause patients to delay or forgo necessary medical treatment, potentially harming their health.
- Financial Strain: These surprise bills can cause significant financial hardship for patients and their families.
Legal Challenges and Regulatory Scrutiny
MultiPlan’s practices have raised serious concerns, leading to:
- Lawsuits: Patients and providers are suing MultiPlan, alleging unfair billing practices and harm to patients.
- Investigations: Regulators are investigating MultiPlan for potential price-fixing and anti-competitive behavior.
What Can You Do?
If you believe you have been unfairly billed due to MultiPlan’s practices, you may have legal options. Our experienced attorneys can help you understand your rights and fight for the compensation you deserve.
Contact Napoli Shkolnik for a free consultation to discuss your case.