Surgery Provider Doesn’t Adequately Challenge Insurer’s Payment Rate, Judge Says

(May 15, 2018, 11:28 AM EDT) -- TRENTON, N.J. — While not perfectly clear, nothing in a health insurance plan requires the insurer to pay an out-of-network provider the amount he billed them rather than the rate they set, a federal judge in New Jersey held May 10 (Rahul Shah, et al. v. Blue Cross Blue Shield of Michigan, No. 17-711, D. N.J., 2018 U.S. Dist. LEXIS 78948)....

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