A recent state review of how BCBSTX processes out-of-network emergency claims found the insurer delayed some claim reviews for ER services and included errors in marketing materials about coverage plans. BCBSTX agreed to reimburse some members for the errors and pay a $10 million fine.
Attorneys for Knox County Hospital District in Knox City said in a press release shared with Becker’s that the state’s finding “demonstrates that a much broader review of BCBS is merited.”
The hospital and BCBSTX are in court-ordered arbitration over a $21 million lawsuit. Knox County Hospital filed a lawsuit against the insurer in September 2019 arguing BCBSTX owed it unpaid claims. Of the case, BCBS of Texas has told Becker’s the insurer can’t comment because of pending litigation.
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