Kaiser Faces Another Case of Unpaid Claims
SAN BERNARDINO, Calif. (CN) - Kaiser refuses to pay for emergency services provided to health plan enrollees, a collection company claims in a Superior Court complaint.
Libramed, Inc. specializes in recovering unpaid medical invoices from Insurance carriers and health plans.
The company alleges Kaiser owes over $50,000 for out-of-network medical services provided by Dr. Amos Kuvhenguhwa for emergency surgeries and other services.
Kaiser is obligated under the California Knox-Keene Health Care Services Plan Act to “reimburse providers for emergency services and care provided to its enrollees, until care results in stabilization of the enrollee,” the complaint states. “Under the act, health care service plans such as Kaiser must pay or contest the claim within 30 days.”
Kaiser, however, paid only a small portion of the charges at “reasonable and customary rates, without contestation,” according to the complaint.
Libramed says Kaiser owes $54,999.56.
The company sued Kaiser Foundation Health Plan, Inc. for recovery of services rendered, recovery of open book account, breach of implied-in-fact contract and quantum meruit under California law.
Libramed seeks compensatory damages plus interest, restitution and attorneys’ fees.
It is represented by A. Douglas Mastoianni, in Long Beach, Calif.