Mayo Clinic sues Sanford Health Plan over unpaid medical bill

 Mayo Clinic sues Sanford Health Plan over unpaid medical bill


Photo: Constantine Johnny/Getty Images

The Mayo Clinic and Mayo Clinic Hospital in Rochester, Minn. is suing Sanford Health Plan over a patient’s unpaid medical bill.

Mayo demands $750,000 in the civil complaint filed December 13 in Minnesota. 

Mayo alleges that Sanford in South Dakota is responsible for $739,956.20 in medical expenses incurred by a patient in the Mayo facilities in 2022.

Mayo asked that the action be removed from the Third Judicial District Court in Olmsted County, Minnesota to federal court in Minnesota.

Sanford wants a dismissal, saying it’s not responsible for the medical expenses for a patient who is on a tribal plan. Mayo has until January 17 to respond.

A motion hearing on the lawsuit is scheduled for Feb. 11, according to keloland.

WHY THIS MATTERS

Mayo is reportedly not charging the patient with the expense.

Mayo alleges Sanford misrepresented its role as the patient’s primary payer, leading to unpaid claims.

Sanford’s dismissal request says Mayo failed to follow standard Medicaid procedure,  

Sanford is the “payor of last resort” it said, and said the patient’s secondary insurance, Blue Cross Blue Shield, should have been billed,

Sanford reportedly preauthorized care and made partial payment but later claimed Blue Cross Blue Shield of North Dakota was the primary payer. Mayo reportedly refunded Sanford’s payments but was denied reimbursement by BCBSND due to lack of preauthorization. 



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Fallon Wolken

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