McKINNEY, Texas (Southeast Texas Record Weekly) – Encompass Office Solutions Inc. has formed a complaint against Blue Cross Blue
Shield after the insurance company allegedly cheated Encompass out of future revenue, and
then declared a new trial when a jury found Blue Shield guilty in the case
the verdict, Blue Cross owed Encompass $26 million in a contract law suit even
though the company was first cleared of the breach of contract in October 2014.
U.S. District Judge Jorge A. Solis saw that Encompass was held at an unfair
standard and re-examined the case, making Blue Cross pay for the $25 million in
future revenue that it cost Encompass.
is filing a complaint after Blue Cross failed to pay $1.4 million in claims and
used its influence to rob the surgical company of future business.
new case dismissed the jury’s “take-nothing decision” after finding that Blue
Cross sent a letter, which told doctors to refuse Encompass’ services.
The letter had threatened to fire doctors who were caught using any of
Encompass’ drugs, equipment, supplies or nurses. Such a letter proved to be
damaging to Encompass since its business thrives off providing those
services to doctors performing in-office surgeries.
said Encompass was held to an unfair standard in the initial processing of
the case because the jury was given wrong instruction.
Encompass alleges that Blue Cross had not gotten in the way with its services, it would
have been a “win-win-win” situation for the patient, physician and insurance
company. The company says Blue Cross should have embraced its services
being that it ensures safety and saves insurance companies money over other
services like it.
in Texas and the surrounding states would be deprived of excellent services and
high-quality care should Blue Cross continue with its letters telling doctors
to not use Encompass, according the plaintiff’s complaints. One patient
described Encompass’ services as “life-saving.”
The case says Blue Cross was “arbitrary and capricious” when it sent letters to
doctors, threatening to fire them should they use Encompass’ services.
Blue Cross alleges Encompass was past its one-year statute of limitation
for making allegations against the insurance company. Encompass still asked for
a new trial and demanded the statute of limitation be dismissed until it
is clear that the claims against them made by Blue Cross in the letter
the court has repeatedly held, knowledge [or an unreasonable lack of knowledge] of falsity is what was necessary for Encompass to be aware of its cause of
action,” Encompass said. “As the jury found, Encompass did not acquire or have
an opportunity to acquire the knowledge until February 2013; therefore, its
claims are timely because the statute of limitations was tolled in the interim.”
letter told doctors that they should not use Encompass’ services because it is
considered an out-of-network provider and that the fees are not covered by the insurer.
However, Encompass says that was not true prior to 2013, while the letter was written in August 2010.