United Healthcare Services has filed a $39 million lawsuit against a Northern California company that manages five outpatient surgery centers, claiming the firm overbilled the insurance carrier and offered doctors financial incentives for patient referrals.
The case filed in Santa Clara Superior Court against Saratoga-based Bay Area Surgical Management is similar to a $20 million suit Aetna brought against the company earlier this year.
The San Jose Mercury News reported that United Healthcare alleges that Bay Area Surgical billed the insurer $69,700 for an arthroscopic knee surgery and $32,300 for two spinal injections, rates dramatically higher than what other providers charge.
Partner Bobby Sarnevesht denies the allegations. He told the Mercury News the insurance companies are trying to strong-arm Bay Area Surgical into signing a contract with unfavorable reimbursement terms.