Lawsuit Filed Against Anthem Blue Cross by Dr. James Ochi Alleges that Anthem Blue Cross Engaged in an Unlawful and Fraudulent Business Practice of Discounting Non-Participating Provider Reimbursement Rates

LOS ANGELES, Oct. 22, 2014 /PRNewswire/ -- Anthem Blue Cross was served with a lawsuit that was filed by the Law Offices of Theresa Barta in San Diego Superior Court on behalf of Dr. James Ochi, a pediatric otolaryngologist who owns an independent practice in San Diego.

Dr. Ochi's lawsuit against Anthem Blue Cross, the largest for-profit health insurer in California, claims that despite being entitled to reimbursement from Anthem Blue Cross as a Non-Participating Provider, Anthem Blue Cross was discounting and reducing Dr. Ochi's rates of reimbursement. 

Dr. Ochi alleges in his lawsuit that Anthem Blue Cross unlawfully and fraudulently treated him - with respect to calculating his claims payments - as a Participating Provider without his consent.

As the lawsuit explains, Dr. Ochi received EOBs (Explanation of Benefits) from Anthem Blue Cross that identified him as a Non-Participating Provider, but showed "Allowed Amounts" that were reduced and discounted well below the "reasonable" rates for Non-Participating Provider charges.

According to the lawsuit, Anthem Blue Cross' actions are unfair and harmful to both doctors and patients, because the lower the amount that Anthem Blue Cross pays to its Out-of-Network providers, the more patients have to pay when they go Out-of-Network.

Dr. Ochi is represented by attorney Theresa Barta of Newport Beach, California, and the lawsuit is filed in San Diego Superior Court. 

To view the original version on PR Newswire, visit:http://www.prnewswire.com/news-releases/lawsuit-filed-against-anthem-blue-cross-by-dr-james-ochi-alleges-that-anthem-blue-cross-engaged-in-an-unlawful-and-fraudulent-business-practice-of-discounting-non-participating-provider-reimbursement-rates-646933913.html

SOURCE Law Offices of Theresa Barta