Arizona AG announced settlement with SimonMed over billing practices

PHOENIX — Arizona’s top prosecutor recently reached a settlement with SimonMed, a medical imaging service provider, in a lawsuit accusing the company of delaying refunds.

“When a medical provider demands an upfront payment, the provider must refund any overpayments within a reasonable time period,” Arizona Attorney General Kris Mayes said in a Tuesday announcement.

She said the Scottsdale-based health company charged customers up front using “good faith estimates” and then took too long to refund them if insurance later showed they had overpaid, adding that some people waited more than a year to get their money back.

What does SimonMed have to do under the settlement?

Now that the state filed a complaint and reached a settlement, SimonMed has to pay $50,000 in civil penalties, $20,000 in restitution and $20,000 in costs and fees. 

It also has to take the following corrective measures:

• Give refunds within about 60 days after insurance finishes processing a patient’s claim.
• Give patients an update on their refund status if their claims aren’t resolved in a timely manner.
• Let patients who disagree with the company’s policy of charging them upfront based on “good faith estimates” keep a credit card on file and be charged only after their insurance company processes the claim.

“Arizonans shouldn’t have to choose between being denied necessary medical services or paying amounts out of pocket that are ultimately covered by insurance,” Mayes said.

Consumers who think they were affected by SimonMed’s billing practices should file a complaint with the Arizona Attorney General’s Office no later than April 30 to be eligible for restitution.

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