Hospital Claims Kaiser Owes $128K for Medical Services
3-24-2017 20:52:00

SANTA ANA, Cal. (CN) – Kaiser refuses to reimburse a hospital over $128,000 for treating its patient, the hospital claims in Orange County Superior Court.

Hoag Memorial Hospital Presbyterian sued Kaiser Foundation Health Plan and Kaiser Foundation Hospitals for breach of written contract and quantum meruit. 
Hoag claims Kaiser will not fully pay for medically necessary services provided to three of its patients between Nov. 4 and Dec.19, 2013.
Hoag says it submitted all the bills on time. Though Kaiser was required to reimburse Hoag within 45 business days, it refused to pay the entire amount owed.
Hoag contacted Kaiser several times demanding payment, but to no avail, the complaint states.
Kaiser knew it had to pay because it entered a written contract with Hoag in 2004 in which it agreed to pay Hoag 90 percent of all billed charges in order to receive discounted medical services, according to the complaint.
Given their agreement, Hoag says, Kaiser’s denial of its claims based on alleged lack of authorization was improper and makes Kaiser ineligible for discounted rates.
Hoag seeks reimbursement of at least $128,378.30, as well as interest and court costs and fees.
The hospital is represented by Celim Huezo with the Helton Law Group of Huntington Beach.