San Francisco-based Dignity Health and Dignity Community Care filed a lawsuit against Gold Coast Health Plan Aug. 24, alleging more than $30 million in unpaid bills.
The Dignity entities, under Chicago-based CommonSpirit Health, include St. John’s hospitals in Ventura County, Calif., and Northridge Hospital Medical Center in Los Angeles County. The complaint, filed in a state superior court, said the health system has identified more than 5,000 medical bills Gold Coast failed to pay at least partially.
According to the complaint, Gold Coast allegedly implemented a new claims processing system in 2024 without sufficient testing or safeguards. The health system also alleged the payer did not supply compliant electronic remittance advices, failed to resolve claims issues, did not pay claims at contracted rates and used improper denial codes with “tens of millions of dollars in claims.”
The health system is requesting a jury trial to determine breaches of contract and the implied covenant of good faith and fair dealing.
Becker’s reached out to Gold Coast, but the insurer declined to comment on pending litigation.
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