New Jersey-based CarePoint Health is suing Horizon Blue Cross Blue Shield over an alleged $76 million in unpaid claims, NJ Spotlight reports.
Here's what you need to know.
1. The insurer didn't pay for more than 7,000 patients between June 2015 and September 20, 2016, the health system claims.
Allegedly, Horizon also denied coverage to patients looking to use any Horizon facility.
2. The insurer accused CarePoint of "price gouges" and said the lawsuit is an attempt to maximize profits.
3. CarePoint allegedly billed customers and insurance companies excessively, the insurer alleges.
4. Horizon said it would file a countersuit.
5. The two companies have a storied past. In 2009, Horizon sued CarePoint saying the center's Bayonne facility submitted false claims. The Bayonne Center filed a counterclaim looking for $100 million from Horizon.
The two companies settled in 2011.
6. CarePoint opted out of coverage in May of 2016. The insurer "essentially refused to acknowledge the bills it has received from CarePoint, to participate in meaningful negotiations, or to pay up."
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