A New Ban on Surprise Medical Bills Starts This Week

Becky1951

Becky1951

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A New Ban on Surprise Medical Bills Starts This Week

For years, millions of Americans with medical emergencies could receive another nasty surprise: a bill from a doctor they did not choose and who did not accept their insurance. A law that goes into effect Saturday will make many such bills illegal.

Article continues at,

https://finance.yahoo.com/news/ban-...OZaitDNiCQTgp4BJQ_FyaoN08rT0_-A8&guccounter=1
 

I can't think of a single unintended consequence to this law. I'm sure medical facilities will be more than happy to provide services for which they don't get paid.
 
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I used to do credentialing for an insurance company that handled medicare and medicaid .....
anyone on the roster at a hospital / clinic / office had to be credentialed .......and approved by insurance company to accept payment from medicaid/ medicare.

When it came to private insurance is this a problem ..... the job to verify if provider is on plan is the job of the customer/ patient

I never understood why in hospital setting they did not do same as companies that process medicaid /medicare

If doctors working in a in network hospital ... although working for that in- network facility.... but an Out of - network provider

I think that issue should have been taken care of by hospitals years ago.
As a matter of employment they should be set up with same plans.

Perhaps a specific doctor did not pass the credentialing....
in that every 3 years we examined education and training .... not going to change over time what changed is adequate malpractice insurance and of course Mistakes/ lawsuits or any questionable behavior.

In many emergency situations...... some out of network providers would accept that insurance rates.
in non emergency someone could and should check if that DR takes a plan.

There is a big difference in what Plan X pays and Plan Y pays etc. some doctors do NOT take certain plans because the very low payment they get for services.
 
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Jeni said:
I used to do credentialing for an insurance company that handled medicare and medicaid .....
anyone on the roster at a hospital / clinic / office had to be credentialed .......and approved by insurance company to accept payment from medicaid/ medicare.

When it came to private insurance is this a problem ..... the job to verify if is on the customer/ patient

I never understood why in hospital setting they did not do same as companies that process medicaid /medicare

If doctors working in a in network hospital ... although working for that in- network facility.... but an Out of - network provider

I think that issue should have been taken care of by hospitals years ago.
As a matter of employment they should be set up with same plans.

Perhaps a specific doctor did not pass the credentialing....
in that every 3 years we examined education and training .... not going to change over time what changed is adequate malpractice insurance and of course Mistakes/ lawsuits or any questionable behavior.

In many emergency situations...... some out of network providers would accept that insurance rates.
in non emergency someone could and should check if that DR takes a plan.

There is a big difference in what Plan X pays and Plan Y pays etc. some doctors do NOT take certain plans because the very low payment they get for services.
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I am surprised how "little" UTMB get reimbursed for certain office visits ($110) and lab work ($5) from BCBS. Remember, the money does not all go to the doctors, but also to cover the cost of overhead of operating a facility, which I believe is very high.
 
win231 said:
"Minutes?" How about seconds?
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Or not at all!!!!! Wife went to an ER for a bout of SVT, and converted before any treatment, They pushed for her to stay overnight for observation, But she refused and we went home. A year later we get a collection notice for $3000 from a Dr group at the hospital for REVIEWING her chart since she signed out AMA. Took 6 months of threatening to sue before they dropped it.....
 
old medic said:
Or not at all!!!!! Wife went to an ER for a bout of SVT, and converted before any treatment, They pushed for her to stay overnight for observation, But she refused and we went home. A year later we get a collection notice for $3000 from a Dr group at the hospital for REVIEWING her chart since she signed out AMA. Took 6 months of threatening to sue before they dropped it.....
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i can see them reviewing any AMA patient chart but that is for their CYA not a service to the patient ... insane they billed on that.

I really see how billing went crazy when so many things became - ala cart in hospitals.
People often do not go line by line on bills and question charges i have and had some knocked off.

I always disliked the term surprise billing........... as some may be in the OUT of Network issue is a surprise but too many think it refers to all billing...
far too many people i know simply not thinking ........if your insurance covers 80% ...then the other 20% of bill is coming to you.
It can be more then you think......
Worst bills ever is for Dr groups in an emergency room .... i have had issues at least 3 times ...
they know and count on people not checking bills for errors
one battle ending up with a large insurance company telling hospital if the emergency doctors group use that biller ........the insurance would take them off their preferred provider list because the biller was doing illegal things.
 
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At my diabetes diagnosis, a doctor stuck his head in the room & said, "I consider you diabetic," & left. I already knew that since my sister tested me with her meter. I was there for 2 hours & I paid the $2,500.00 bill before I left.
A couple of weeks after I got home, I got bills for several thousand dollars from other medical facilities I'd never been to. I phoned the hospital to ask what they were for.
They explained: "We sent your charts to other doctors for evaluation, so you have to pay them, too."
I replied: "That wasn't necessary, so if you did that--which I don't believe you did--YOU can pay them."
 
win231 said:
At my diabetes diagnosis, a doctor stuck his head in the room & said, "I consider you diabetic," & left. I already knew that since my sister tested me with her meter. I was there for 2 hours & I paid the $2,500.00 bill before I left.
A couple of weeks after I got home, I got bills for several thousand dollars from other medical facilities I'd never been to. I phoned the hospital to ask what they were for.
They explained: "We sent your charts to other doctors for evaluation, so you have to pay them, too."
I replied: "That wasn't necessary, so if you did that--which I don't believe you did--YOU can pay them."
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that sounds fishy why are so many needed to review a chart........ again think that is more about them playing CYA.

If their Drs need so much reassurance or double checking of their charts/work ......... perhaps they need to review their employment.
 
win231 said:
At my diabetes diagnosis, a doctor stuck his head in the room & said, "I consider you diabetic," & left. I already knew that since my sister tested me with her meter. I was there for 2 hours & I paid the $2,500.00 bill before I left.
A couple of weeks after I got home, I got bills for several thousand dollars from other medical facilities I'd never been to. I phoned the hospital to ask what they were for.
They explained: "We sent your charts to other doctors for evaluation, so you have to pay them, too."
I replied: "That wasn't necessary, so if you did that--which I don't believe you did--YOU can pay them."
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MAN ALIVE: Reading these posting sure makes me glad I live in Canada with our lovely medical care paid from our taxes. I don't care cold it gets because I know if I need to see a doctor I don't have any bills to pay. These posting are making think that some doctors sure are greedy for money. They want all of your money and you can take out a 2nd or 3rd mortgage to pay them. Put the Mafia in a better light. Good system if you are military type or Big Shot Hollywood. What about the majority of the population? Are you suppose to die? Doesn't sound fair to me but maybe I'm missing some information here?
 
Packerjohn said:
MAN ALIVE: Reading these posting sure makes me glad I live in Canada with our lovely medical care paid from our taxes.
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If you research the statistics, it quickly becomes apparent that people in the U.S. pay almost Twice as much for healthcare, compared to most other nations. Yet, in terms of quality of care, etc., we rank number 37....according to the WHO.

I'm not a real fan of "Socialism", but Universal Healthcare is one area of that philosophy that our nation sorely needs to embrace, IMO. Our "For Profit" system is Raping our people. Sure, it would require more taxes, but compared to the current costs of maintaining all of our corporate health care and insurance systems, most of our people would get a nice pay raise.

If you look up the top 10 highest paid Careers, 7 of them are in the Medical arena. However, since our "Health Care Industry" is right at the top of donations to our political campaigns, I doubt we will see any meaningful changes in the foreseeable future.

We used to have a "Medical Profession". In the past few decades, that has become known as our "Health Care Industry". They are finally telling us the truth....the Primary purpose of Any Industry is to Make Money,
 
Packerjohn said:
MAN ALIVE: Reading these posting sure makes me glad I live in Canada with our lovely medical care paid from our taxes. I don't care cold it gets because I know if I need to see a doctor I don't have any bills to pay. These posting are making think that some doctors sure are greedy for money. They want all of your money and you can take out a 2nd or 3rd mortgage to pay them. Put the Mafia in a better light. Good system if you are military type or Big Shot Hollywood. What about the majority of the population? Are you suppose to die? Doesn't sound fair to me but maybe I'm missing some information here?
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The system here is overly problematic a great deal is tied to CYA and lawsuits.

Much like other service items a Consumer needs to at the very least ....ask more questions.
Question what is this test or what is that test is for? what are treatment options? estimates of costs.... other options
We still have drug companies greasing the wheel to get dr to prescribe NEW expensive drugs...... even if a lower cost alternative was available etc.

The doctor is your employee not the other way around...
like any business like plumber or mechanic some just do what needs to be done.................others wonder how much add on can they do.

Some folks just say well "doctor said so" ....no questions no second opinion etc. Some doctors simply do not know what this or that cost if they look it up often in my experience they say "OH we can do this instead to see if that works first"

In the posts above if a doctor asked can i have another person look at your chart to see if they have another view and you said OK then bill..... definitely not if they decided without you.

I imagine people going into a nice restaurant letting the staff decide you need the most expensive bottle of wine and the most expensive item on the menu too...then a fancy dessert and any add on they can find........ not asking you just ordering it for you.

I believe a good medical experience should be a business deal both sides need to be informed and open to debate of what will be done.
Some items maybe you need to do research on...

Patients do not follow instructions it is estimated 75 % do not take medication as instructed as well.
Doctors will do any test possible so if some item is serious they can show they tested for everything even if unneeded.

I can see if a condition ends badly ........A lawyer wants to hold medical responsible ..........even if patient did not do anything to be a part of solution.

Maybe we should have comparable negligence .... like some places have with car insurance.

what does not show in stats comparing to other health systems is lawsuits
many universal healthcare countries have limits set for damages or malpractice here it is shoot for the stars cause lawyer is taking half
 
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