Rudolph v. Pennsylvania Blue Shield

TAMILIA, Judge.

Pennsylvania Blue Shield appeals from the judgment entered upon the April 3, 1995 Order confirming an arbitration award in appellees’ favor in the amount of $110,580.30.

The medical services underlying this action were performed by appellees, a Blue Shield participating physician and his professional corporation, for appellant’s customers between June, 1986 and November, 1987. However, charges for some of the procedures performed by appellees were denied by appellant on the basis that they were neither medically necessary nor cost effective. Thereafter, pursuant to statute and…