"In the major litigation, we’ve seen victories both on the provider and on the plan side," Mr. Kopson said. "One thing that is abundantly clear: This type of litigation is extremely complex and it is extremely expensive."
For this reason, it helps to have multiple health providers involved in a class action against insurers or a medical organization that supports the plaintiff physician, he said. Considering the value of the claim is also important before suing, Ms. Woodcock said. In some cases, the cost of attorney and legal expenses far exceed the disputed payment amount, she noted.
Legal standing is another major consideration, Mr. Selesnick said. Doctors should determine whether they have grounds to sue insurers, with an eye toward legal rules and contract terms. Legal counsel is key, Mr. Selesnick said.
Of course, resolving questions and conflicts with insurers early can prevent lawsuits all together and save both sides significant time and expense, Mr. Kopson said.
"Health plans and providers are undeniably in a symbiotic relationship," he said. "It means you have to pursue a collaborative – as opposed to an adversarial – posture. The best way to avoid litigation is to engage in vigorous discussion and negotiation up front before the contract is signed."
*Correction 2/26/14: A previous version of this story gave the incorrect middle initial of Mr. Mark S. Kopson. This version has been updated.