Blue Shield of California Sued for Failing to Properly Pay for Prosthetic Leg Components to Out-of-Network Providers

Two members of Blue Shield of California’s insurance plan have sued the company. In their lawsuit, among other claims, they claim that the company fails to properly compensate out-of-network prosthetists for leg components. This has resulted in some individuals suffering from limb loss in being forced to pay out of pocket for some prostheses.

According to the lawsuit, Blue Shield of California has implicitly promised to its customers that it would provide an adequate network of prosthetists from which its customers could choose. However, the lawsuit claims that prosthetists are not properly paid for prosthetic leg components. This has resulted in a small network of prosthetists who are contracted with Blue Shield. As a result, many customers are unable to work with an in-network prosthetist, and are forced to seek the services of an out-of-network prosthetist.

The lawsuit alleges that Blue Shield has such low contracted rates that the vast majority of prosthetists refuse to enter into a contract with the company. One of the plaintiffs was forced to pay almost $20,000 out of pocket for his new prosthetic device. The lawsuit is asking that the company reimburse customers who had to pay out-of-pocket for prostheses, as well as change its policies going forward.

If you are suffering from limb loss and your insurance company has improperly reimbursed you for a prosthesis, you should speak with an attorney. Call me, Conal Doyle, Los Angeles personal injury attorney, at 310-385-0567. We can help. Call today to learn more or to schedule a free consultation.