AmeriChoice, which is a TennCare managed health care insurance provider, may be required to pay Erlanger Health additional costs for medical services given to hundreds of patients who suffered an emergency condition.
A Davidson County judge had dismissed Erlanger’s claim that the UnitedHealthcare-owned insurance provider did not pay fair market value for provided medical services, but the Chattanooga health system appealed that decision.
The court of appeals ruled in Erlanger’s favor last week, so the case will now likely be presented to a jury, in keeping with the appeals court opinion.
Steven A. Riley, who is representing Erlanger, said during oral arguments the hospital uses the example of Ron, which is a fake name, to explain what the situation can look like.