California Court of Appeal

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Pacific Bay Recovery v. Cal. Physicians' Services, 070561

In an action by an out-of-network provider of medical services against Blue Cross-defendant to recover the additional unpaid amount it claimed to be owed for services rendered to a patient insured by defendant, the trial court's judgment sustaining defendant's demurrer is affirmed where, on the record, Blue Shield is not obligated to pay plaintiff, an out-of-network nonemergency provider, a usual, customary, and reasonable rate for services plaintiff provided to a Blue Shield subscriber.

Appellate Information

  • Decided
  • Published 2017/05/31




  • California Court of Appeal