Mercy files $4.1M suit against Aetna for allegedly withholding reimbursement

Chesterfield, Mo.-based Mercy has filed suit against Aetna, claiming the health insurance company has failed to pay the full, agreed upon amount for care provided to certain newborn babies, reports St. Louis Post-Dispatch.

The nonprofit Catholic health system filed suit Friday in U.S. District Court for the Eastern District of Missouri. The suit named both Aetna and Aetna's Medicaid plan for Missouri residents, known as Aetna Better Health of Missouri, as defendants.

The complaint alleges Aetna violated an end-of-payment agreement the two organizations first enacted in 2007. Mercy claims Aetna has either underpaid or failed to pay for services provided to newborns in its neonatal intensive care unit at Mercy Hospital-St. Louis since July 1, 2014.

As of Jan. 22, 2016, Mercy claims Aetna owes about $3.3 million in outstanding claims associated with underpayments and $833,000 in payments that have yet to be made, according to the compliant obtained by St. Louis Post-Dispatch.

Aetna told Post-Dispatch it hasn't been served with the suit.

 

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