UnitedHealthcare pays providers in The Villages, Leesburg $4.7M after denying to reimburse them for treatment
UnitedHealthcare Insurance Co. has paid over $4.7 million to UF Health The Villages Hospital and UF Health Leesburg Hospital after it lost a case of denying more than 1,000 claims.
The Villages and Leesburg hospitals had a contract with Unitedhealthcare to pay a certain rate formedical costs if one of its members came into the hospital and received treatment, and in exchange, these hospitals would act as providers under United’s insurance. The amount that the health insurance company would reimburse per treatment depended on a number of factors.
After people with UnitedHealthcare insurance received treatment at these hospitals, UnitedHealthcare repeatedly tried to avoid repaying hospitals for the cost of treatment, the lawsuit alleged.
UnitedHealthcare argued in part that its members had gotten treatment that was not medically necessary, so it did not have to pay medical costs for those procedures.