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and life along the winding road

Tuesday, March 4, 2014

Balance Billing

One of the annoying things about health care in the U.S. (one of many) is that just because you go to a doctors office or hospital that is within your insurance network, it doesn't mean the actual doctor who you see is also in the network (they have to individually negotiate a contract with the insurance company). Often the reason they haven't signed a contract is because the doctor doesn't want to take the lower rate the insurance company offers. Obviously if you are in the E.R. for an emergency, you don't stop to ask if the doctor on call is within the network, but what happens is the patient ends up paying an exorbitant higher amount for services.

If you're in Texas you can read about policies at the Center for Public Policy Priorities.

If your bill is $1,000 or more, you can ask the Texas Department of Insurance to mediate for you or contact the Office of the Attorney General. (They may look into bills that are less than $1,000)

You can check rates for procedures here (make sure you get an itemized bill)

NBC News showed a special report regarding new state rules.

You can watch the video here