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TeamHealth provides ER care. Photo: Brittany Murray/MediaNews Group/Long Beach Press-Telegram via Getty Images

Health insurance company UnitedHealthcare is suing TeamHealth, a company that staffs hospital emergency rooms, alleging TeamHealth billed for more expensive ER services that didn't match the care doctors actually provided.

Why it matters: This is another alleged instance of "upcoding," which has existed in health care for many years and leads to everyone paying higher medical premiums.

Driving the news: UnitedHealthcare analyzed ER claims and records from TeamHealth, saying they found 62% of TeamHealth's claims involving the highest-paying ER codes were unjustified by notes in medical records.

  • In one example, a 23-year-old man in Texas went to an ER staffed by TeamHealth "complaining of epigastric pain after eating a chili dog," according to the lawsuit. Doctors gave the man Maalox, a common antacid for heartburn, and sent him on his way.
  • TeamHealth used the highest-severity ER code reserved for things like heart attacks or severe trauma, and charged $1,712 for the visit, UnitedHealthcare alleges.

The other side: TeamHealth CEO Leif Murphy submitted a statement to Axios that said, "Courts have repeatedly dismissed these claims in other jurisdictions ... United continues to generate record profits by down coding claims and refusing to consider the expertise of frontline clinicians who make a diagnosis."

Flashback: UnitedHealthcare and TeamHealth have a history of suing each other, with TeamHealth saying the insurer routinely underpays.

Editor's note: This post was updated to add comments from TeamHealth.

Go deeper

Updated 1 hour ago - Health

The next big bottleneck in the global vaccination effort

Illustration: Rae Cook/Axios

The world still needs more coronavirus vaccines, but an additional bottleneck has emerged in many low-income countries: They need help getting shots in arms.

Why it matters: Increasing vaccination rates across the world is both a humanitarian necessity and the best way to prevent dangerous new variants from emerging, but it increasingly requires complex problem-solving.

Updated 2 hours ago - Health

COVID-19 Omicron variant cases identified in Europe, U.K.

People wearing masks walk in London on Nov. 25. Photo: Li Ying/Xinhua via Getty Images

Health officials in the United Kingdom, Italy and Germany announced on Saturday that they've detected the first known cases of the new COVID-19 Omicron variant.

Why it matters: The discoveries come as the world scrambles to respond to concerns over the new variant, discovered in South Africa earlier this week.

Black Friday in-store shopping up from 2020 but trails pre-pandemic levels

Shoppers carry their purchases during Black Friday shopping at Fashion Outlets of Chicago in Rosemont of Greater Chicago Area, Illinois on Nov. 26, 2021. Photo: Joel Lerner/Xinhua via Getty Images

More shoppers flocked to stores on Black Friday this year compared to last, but online shopping was lower than expected, according to data from Friday.

Driving the news: Online shopping was on the lower end of what was expected, largely because people had been ringing up their shopping carts earlier in the year in an effort to skirt potential supply chain issues, according to the Adobe Digital Economy Index.