Riverdale, Ga.-based Southern Regional Medical Center is suing Cigna, alleging the payer did not fully reimburse SRMC for medically necessary services as an out-of-network provider, The Clayton Crescent reported Aug. 3.
Southern Regional Medical Center alleged in the lawsuit filed in Fulton County Superior Court that Cigna "systematically failed and refused to fully and properly pay" it for the reasonable value of the services it provided Cigna's members from 2019 to May 2020, according to the report.
The medical center said that while Cigna paid for some claims, for hundreds of claims, it paid "far less than the reasonable value for those services."
South Regional Medical Center is seeking the reasonable value of the medically necessary hospital services it provided — with the exact amount to be proven at trial — plus interest, according to the report. It is also seeking restitution and/or damages plus interest for Cigna's alleged unjust enrichment and damages plus interest for the payer's alleged breaches of implied contracts.
Becker's reached out to Cigna for comment and will update this story if more information becomes available.