A lawsuit challenging Montana Blue Cross-Blue Shield over a claim denial for spine surgery is allowed to move forward, LegalReader.com reported June 20.
The judge ruled that the case could be expanded into a class-action lawsuit, the report said. Attorneys involved in the case said the insurer flagged claims above $50,000 and skipped important steps in the review process.
During the process reviewers allegedly didn’t look at all available records or speak with the surgeons who provided care, the report said. In one instance a physician who denied a claim said she reviewed it despite not having a background in spine conditions.
According to a June 16 report from the Daily Montanan, the lawsuit involved a patient with a collapsed vertebrae in his spine.
A spokesperson for BCBS said in a June 23 email to Becker’s that the insurer doesn’t comment on pending litigation. Health Care Service Corporation, the parent company of Montana Blue Cross-Blue Shield, told the Daily Montanan that it won’t comment on pending litigation.
