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Eleven surgical centers and hundreds of their patients are suing Blue Cross and Blue Shield of Georgia.
In the lawsuit filed this week, the centers allege the insurer is overcharging those with preferred provider organization policies, or PPO policies, while reimbursing out-of-network doctors less than they did several years ago. PPO policies allow patients to visit both in-network and out-of-network doctors.
Former Georgia Insurance Commissioner John Oxendine is representing the surgery centers and their patients. He says on average, PPO policy holders are being overcharged 25 percent on their monthly policies and are paying 20 percent more than they should in out-of-pocket costs when they visit an out-of-network doctor.
“The problem is they told the public they were going to pay out-of-network doctors more; and therefore, we have to charge you more money as a policyholder,” says Oxendine. “They changed their policy and did not reduce the price to the consumer.”
In a statement, Blue Cross and Blue Shield of Georgia says “Blue Cross and Blue Shield of Georgia does not discuss the details of pending litigation. Nevertheless, the allegations are unfounded. Further, we believe these surgery centers were properly compensated for their services. Our goal at all times is to serve the best interests of our customers, ensuring that they have access to the best, most advanced health care available.”