UnitedHealthcare and TeamHealth have settled a lawsuit in which the insurer accused the physician staffing company of upcoding emergency department claims.
The lawsuit was voluntarily dismissed with prejudice Sept. 24 in Tennessee federal court, according to court records. The dismissal comes after the payer and hospital staffing company told the court Aug. 11 they had reached an agreement in principle to resolve the case.
UnitedHealthcare filed the lawsuit in October 2021, alleging that TeamHealth deliberately upcoded ED claims to induce the insurer to overpay. The payer said its review of TeamHealth claims and medical records found that 62% of claims billed under the two highest-paying ED codes, CPT codes 99285 and 99284, were not supported by records. UnitedHealthcare estimated it had overpaid about $100 million on TeamHealth claims since 2016.
Terms of the settlement are confidential, according to the Sept. 24 filing.
UnitedHealth Group and TeamHealth did not immediately respond to messages seeking comment.
In separate news, UnitedHealthcare named Bobby Hunter president Sept. 28. Mr. Hunter most recently served as CEO of government programs at the insurer.
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