Plan Sues Blue Cross For Their Own Claims Data

“We finally have a plan sponsor with the guts to do this,” Tony Sorrentino, a lawyer who is president of Health Plan Fiduciary Compliance LLC, a health-care compliance consulting firm based in Parker, Colo., said in an interview.

The lawsuit charges that Blue Cross, the plan administrator for a self-funded health plan, repeatedly refused to turn over their client’s own claims data. When someone says you can’t see a contract or review your own claim data, you are probably paying too much. Any TPA who refuses to let a plan sponsor see their own claim data should be replaced with one that will.

READ ARTICLE HERE: Suit Against Anthem Exposes Conflict Over Health Claims Data

RELATED BLOG POSTING: The Truth About The Blues

“They ought to fire their TPA and get another record keeper. Or are they planning to stay with them win or lose?”