What are the usual, customary and reasonable rates for which health insurance company will reimburse their insureds for services provided by an out of network doctor or hospital? A class action lawsuit filed in Florida claims that health insurance companies artificially and wrongfully deflate these reimbursement rates, thus costing consumers and families millions of dollars annually.
Last year New York Attorney General Andrew Cuomo reached a settlement of a lawsuit regarding the reimbursement rates paid by health insurers, after a study showed that they were routinely paid at rates 10% to 28% lower than their actual costs to insured families. For instance, an example mentioned in the lawsuit was an MRI for which Blue Cross reimbursed $419, although it's actual cost to the patient was $1281.
Source: Palm Beach Post