Automobile medical payments

[IRCOS, LLC]

I am assisting an attorney to identify a litigation consultant and/or expert witness.

There is litigation between physicians, who render medical care to patients covered under the medical payment section of auto policies, and insurers, who applied PPO discounts to their bills without the advance knowledge of the physicians.

The physicians, who are members of PPOs, contend that some the PPOs that they are affiliated with had sold or leased their names to auto insurers that took advantage of the PPO discount, without channeling patients to the physicians.

The question to the prospective consultant and/or expert witness is: should insurers that took advantage of PPO discounts channel patients to the physicians even if they are contractually not required to do so? If yes, can the prospective consultant and/or expert witness cite any auto insurers who take advantage of PPO discounts channel patients to physicians? I am assisting an attorney who is involved in a dispute between physicians who render medical care to patients covered under the medical payment section of auto policies and insurers who applied PPO discounts to their bills to identify a litigation consultant and/or expert witness.

The physicians, who are members of PPOs claim that the PPOs sold or leased their names to auto insurers who took advantage of the PPO discount, without channeling patients to the physicians.

The question to the prospective consultant and/or expert witness is: should insurers that took advantage of PPO discount channel patients to the physicians even if they are contractually not required to do so? If yes, can the prospective consultant and/or expert witness cite auto insurers who are channeling patients?