Surprise Medical Bills
American patients still face plenty of financial challenges that people in the rest of the developed world do not: high out-of-pocket costs, unaffordable medications, and millions still left uninsured. But the particularly egregious practice of surprise billing... is finally coming to an end - Dylan Scott
image by: Karolina Grabowska
HWN Suggests
A New Ban on Surprise Medical Bills Starts Today
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... will make many such bills illegal.
The change is the result of bipartisan legislation passed during the Trump administration and fine-tuned by the Biden administration. It is a major new consumer protection, covering nearly all emergency medical services, and most routine care.
“I think this is so pro-consumer, it’s so pro-patient — and its effect will eventually be felt by literally everybody who interacts with a health care system,” said Senator Bill Cassidy, a Republican…
Featured
Why Ambulances Are Exempt From the Surprise-Billing Ban
The welter of providers, layers of state and local regulation, and lack of information about costs made lawmakers hesitant to take up the issue. But that may change.
Articles of Interest
Congress finally plans to put a stop to surprise medical bills
The days of surprise medical bills should soon be over.
Get Rid of Surprise Medical Bill
Scott Kohan woke up in an Austin, Texas, emergency room after an attack that broke his jaw. The hospital was within his insurance network. But the oral surgeon who set his jaw wasn’t. Mr. Kohan’s insurer refused to pay the surgeon’s $8,000 bill. He’s not alone. An estimated 51% of ambulance rides, 22% of emergency-department trips, and 9% of elective cases, in which patients have time for due diligence, lead to surprise bills. These typically come from providers who refuse to join insurance networks so they can charge astronomic
Here's what the new ban on surprise medical billing means for you
It generally forbids insurers from passing along bills from doctors and hospitals that are not covered under a patient's plan — such bills have often left patients to pay hundreds to tens of thousands of dollars in outstanding fees. Instead, the new law requires health care providers and insurers to work out a deal between themselves.
How To Handle A Surprise Medical Bill And Keep Health Costs Under Control
“It’s estimated that up to 80% of medical bills contain errors,” says Thomas Nitzsche of Clearpoint, a nonprofit Atlanta-based credit counseling agency.
New Rule on Surprise Billing Aims to Take Patients Out of the ‘Food Fight’
Neutral arbiters are given guidance on how to settle disputes between insurers and medical providers.
Surprise Medical Bills Are Driving People Into Debt: Will Congress Act To Stop Them?
Surprise medical bills — those unexpected and often pricey bills patients face when they get care from a doctor or hospital that isn't in their insurance network — are the health care problem du jour in Washington, with President Trump and congressional lawmakers from both sides of the aisle calling for action.
Surprise medical bills increase costs for everyone, not just for the people who get them
Evidence from our recent study suggests that everyone with commercial health insurance is paying higher premiums today because lawmakers allow the practice of surprise billing to persist. Fixing surprise billing won’t just help the patients being billed; it offers the potential to lower health insurance premiums for everyone.
The Hidden Cost of ‘Surprise’ Medical Bills
Efforts to fix the problem through legislation have been halting, largely because the issue pits three powerful players in the health care industry–hospitals, physicians’ groups and insurance companies–against one another. Those groups all know that any new law shielding patients from surprise bills would require one of them to eat those costs instead.
The Surprising Economics Of Surprise Medical Bills
The risk is that enrollees who are surprised will become irritated and switch to another insurer. But insurers are more than happy to see that happen. After all, people who use a lot of hospital services are likely to be unprofitable customers anyway. Both at the state and the federal level there has been pressure to do something about this problem.
US doctors keep lobbying for things that make American healthcare so expensive
A new law coming into effect on Jan. 1, known as the No Surprises Act, prohibits surprise billing, forcing instead providers and insurance to settle the payment among themselves. This will be a great relief for patients, who cite surprise billing as a major concern when it comes to healthcare costs. Nearly 40% of patients report having received at least one surprise bill, and 60% say they are concerned about the issue.
Resources
5 Horror Stories About the Cost of Health Care Even When You Have Insurance
"After a car accident, an emergency services bill grew to $75,000. We decided declaring bankruptcy was our only option."
No Surprises Act
Review rules and fact sheets on what No Surprises rules cover, and get additional resources with more information.
