Cigna sues ambulatory center for out-of-network strategy

Cigna has sued an ambulatory care center, claiming it incorrectly waived patients' copays and deductibles when they went to out-of-network facilities. The insurer wants the Roseland Ambulatory Surgery Center in New Jersey to repay more $6.6 million, which it received for about 1,400 patients who weren't billed appropriately, reported The Record. "There are a number of facilities and doctors in New Jersey that pursue an out-of-network business model," Cigna Spokesman Phil Mann told The Record. That practice is responsible for "driving up claim costs, with significantly higher charges than those billed by in-network doctors and facilities," he said. "The waiver of cost-sharing as a routine business practice is deceptive and fraudulent. Providers who engage in this are driving higher costs for all New Jersey consumers," he added. Article

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