Out-of-Network Illinois Surgery Center Battles Aetna Over $3.4M in Bills

Oak Brook Surgical Centre and insurance company Aetna are battling in court over $3.4 million in bills, according to a Crain's Chicago Business report.

Oak Brook Surgical Centre submitted nearly 280 claims to the insurance company between 2005 and 2010, according to a financial report by the surgery center. Aetna has paid approximately $341,000, or less than 10 percent of the total $3.8 million billed, according to the report.

The surgery center contends it reasonably relied on Aetna's assurances that the claims would be covered and that the court should prevent the insurer from rescinding those statements. Aetna disputes the claims of Oak Brook Surgical Centre, which is not part of Aetna's network of providers.

Conflicts between out-of-network surgery centers and insurers are growing, as insurance companies use intimidation tactics to avoid paying the generally higher charges billed by non-contracted facilities.

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