A Plano company told local doctors that it could help them get a whole lot of money from health insurance companies. That didn’t happen — and now the docs are taking their case to court.

Medical Practice Solutions is a privately held company founded in 2010. It's like a middleman between health insurers and providers, helping clinicians to simplify the billing process and reduce overhead, according to a description on its LinkedIn page.

But Neuron Shield Partners and its business affiliates — who get paid to monitor the nervous systems of patients during surgery — accuse the company of overstating its capabilities.

Medical Practice Solutions allegedly claimed that it could get reimbursements of $50,000 or more on out-of-network claims. It promised a “a higher percentage of revenue per claim compared to any other biller,” said a lawsuit filed this month in the Eastern District Court.

But the majority of the reimbursements for surgical monitoring amounted to far less, and most insurers paid nothing at all.

Medical Practice Solutions’ “secret sauce” was just “random luck masquerading as talent,” the complaint said.

Calls to Medical Practice Solutions for comments from the two individuals being sued, Adrianna Villarreal and Anthony Casarez, were not immediately returned. The company's website is currently under construction.

Dr. David Masel and Dinesh Chandiramani of Neuron Shield, also based in Plano, could not be immediately reached. The voice mailbox was full and not accepting messages.

The lawsuit's claims are raising some eyebrows.

“It’s kind of greed on greed,” said Dennis Jay, executive director of the Coalition Against Insurance Fraud based in Washington, D.C.

Neuron Shield provides a service that monitors patients' nervous systems during complex operations, like spinal surgery. Its clinicians alert surgeons if the spinal cord or nerves have stopped functioning properly in order to help reduce the risk of postoperative disability.

However, with more attention being placed on value in health care, there has been push back from researchers, who worry that the service is overused and could lead to extra costs for patients.

The data is mixed. A 2014 study concluded that monitoring increased the length of surgery and added about $1,535 per case, but did not add additional benefit, while a 2015 study found the extra surgical service led to better clinical outcomes for certain patients.

That lack of clarity can be an issue for health insurance companies as they evaluate payments. And it ultimately becomes an issue for patients who get charged “surprise bills” for services.

“A lot of energy goes into finding ways to take money out of the health care system,” Jay said.

The costs listed in the lawsuit are what stand out to economists and neurologists. Neuron Shield said it provided over $190 million in intraoperative monitoring services to patients since about 2015, according to the lawsuit filed on Aug. 1.

Neuron Shield would have needed to bill for over 40,000 procedures at three times the average rate that Medicare pays to generate that amount of revenue, some estimate.

Even more, in 2013 the federal government said doctors could only monitor one procedure at a time. That led to fewer claims for that sort of monitoring.

"The real question is how many patients did they see and what were they charging," said Dr. John Ney, assistant professor of neurology at Boston University and lead author of the 2015 study.

"Companies can charge what they want. The sky is the limit," he said. "But there's a big discrepancy between what's charged and what's reimbursed."

Neuron Shield said it contracted with Medical Practice Solutions to collect on claims but recouped less than $11 million of the $190 million that it billed insurers.

Most of those reimbursements came from just one health insurer, United Healthcare, where one of the founders of Medical Practice Solution used to work, the lawsuit said.

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Correction: The estimated amount of claims the company needed to bill to reach $190 million was also corrected from the original version from over 4 million to 40,000.