The North Carolina Medical Society has sued UnitedHealthcare, claiming the payer has harmed doctors with unfair business practices that deny and delay payments for medical care.
Instead of asking for monetary damages, the suit asks a Wake County Superior Court in Raleigh for a ruling that will force UnitedHealthcare "to change its deceptive, unfair and unlawful business practices."
The organization, which represents nearly 12,000 physicians and physician assistants practicing in North Carolina, said in April that it would sue.
In a news release Friday announcing the filing, the society said it met Jan. 8 with UnitedHealthcare executives in Greensboro and at the company's headquarters in Minneapolis to discuss its members' concerns.
"Those issues include nonpayment of claims dating as far back as three years, coding errors, denial of coverage for services deemed medically necessary, poor communication efforts and bad faith in contract negotiations," the release said.
The society's CEO, Robert Seligson, said requests for change were ignored.
"This lawsuit is a last resort that will force United to conform to acceptable business practices," he said. "We have exhausted all other avenues. United has put us in a position where we are forced to take legal action."
Roger Rollman, spokesman at UnitedHealthcare's North Carolina headquarters in Greensboro, said the HMO has already made "a considerable investment to develop resources that physicians and physicians' offices can use to make UnitedHealthcare easier to work with."
He cited as one example an online system that allows doctors and their staffs to make electronic claim submissions and check the status of claims.
"It is UnitedHealthcare's strong belief that the issues that the physicians and the medical society might raise can be resolved by sitting down together and working together, and that litigation is not a route that is going to result in a rapid resolution of issues," he said Friday.
More than 13,000 doctors and 110 hospitals are part of United Healthcare's network in North Carolina. The system serves more than 850,000 people in the state through all its services, Rollman said.
The society filed a similar lawsuit in January against Blue Cross and Blue Shield of North Carolina. That action is similar to national legal challenges against Aetna, Cigna Corp. and other national for-profit insurers.
In March 2003, Aetna agreed to pay $170 million to settle a class-action suit by 700,000 doctors who alleged unfair business practices. Cigna agreed in September to spend $540 million to correct what physicians said was a pattern of systematically denying and delaying payments.