A judge has granted class-action status to a lawsuit claiming Benefis Health System in Great Falls, Mont., owes patients money that it collected in excess of what health insurance companies were contractually obligated to pay, according to a Great Falls Tribune report.
Shannon Conway filed the suit, claiming he received care at Benefis in July 2011 at a cost of $2,073.65. Under a preferred provider agreement, Mr. Conway's insurer, TRICARE, paid Benefis $662.74 — the negotiated amount TRICARE would pay. Mr. Conway's auto insurance was also slated to cover $1,866.29 from the accident.
Mr. Conway asked the auto insurer to pay him directly, but it mistakenly paid Benefis. Benefis returned the $662.74 to TRICARE, which it had an agreement with, and kept the difference of $1,203.55, according to the lawsuit.
Mr. Conway claims TRICARE was responsible for settling the hospital bill regardless of whether a third-party payor, in this case his auto insurance, was involved. The suit claims Benefis defrauded Mr. Conway by keeping money he feels he was entitled to while returning money to TRICARE, which should have covered the claim.
An attorney representing Benefis offered the following comment in the report: "While we [obviously] disagree with the allegations that have been made, it is our belief and position that cases should not be litigated in the press."
Benefis has 30 days to appeal the court's ruling granting class-action status to the case.
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Shannon Conway filed the suit, claiming he received care at Benefis in July 2011 at a cost of $2,073.65. Under a preferred provider agreement, Mr. Conway's insurer, TRICARE, paid Benefis $662.74 — the negotiated amount TRICARE would pay. Mr. Conway's auto insurance was also slated to cover $1,866.29 from the accident.
Mr. Conway asked the auto insurer to pay him directly, but it mistakenly paid Benefis. Benefis returned the $662.74 to TRICARE, which it had an agreement with, and kept the difference of $1,203.55, according to the lawsuit.
Mr. Conway claims TRICARE was responsible for settling the hospital bill regardless of whether a third-party payor, in this case his auto insurance, was involved. The suit claims Benefis defrauded Mr. Conway by keeping money he feels he was entitled to while returning money to TRICARE, which should have covered the claim.
An attorney representing Benefis offered the following comment in the report: "While we [obviously] disagree with the allegations that have been made, it is our belief and position that cases should not be litigated in the press."
Benefis has 30 days to appeal the court's ruling granting class-action status to the case.
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