Envision Healthcare is one of the largest physician staffing firms in the country. It was taken private in a $5.5 billion deal in 2018. It sued insurer UnitedHealthcare for underpayment of emergency room services, recently winning a $91 million judgement.
Envision CEO Jim Rechtin alleges UnitedHealthcare routinely denied claims for commercial members who were among the sickest and sought care at an emergency room. Rechtin called UnitedHealth’s alleged practice “cold, callous and inhumane,” according to a statement released Friday announcing a lawsuit was filed in a Tennessee federal court.
UnitedHealthcare countersued Envision for allegedly exaggerating patient claims and padding their bills.
UnitedHealthcare alleged Envision, one of the largest physician staffing firms in the U.S., has “systematically deceived” the insurer into overpaying through a practice known in the industry as “upcoding,” according to a lawsuit filed in a federal court in Tennessee on Friday.
Upcoding is a common practice that is hard to prove and harder to eradicate.