{"id":4545,"date":"2019-05-29T10:11:09","date_gmt":"2019-05-29T10:11:09","guid":{"rendered":"https:\/\/medisysdata.com\/?p=4545"},"modified":"2023-10-15T09:04:43","modified_gmt":"2023-10-15T03:34:43","slug":"healthcare-industry-needs-a-solution-for-surprise-bills","status":"publish","type":"post","link":"https:\/\/www.medisysdata.com\/blog\/healthcare-industry-needs-a-solution-for-surprise-bills\/","title":{"rendered":"Healthcare industry needs a solution for surprise bills"},"content":{"rendered":"\r\n

Patients usually do everything right. They choose an emergency department, a hospital, or an obstetrician in their health plan\u2019s network. Yet they often receive care at some point from an emergency room doctor, anesthesiologist, or another clinician who is an \u201cout of network\u201d provider. Weeks later, a bill arrives asking for the difference between what the health plan covers and the doctor\u2019s actual fee. Patients rightfully feel blindsided and infuriated.<\/p>\r\n\r\n\r\n\r\n

A bipartisan group of senators recently introduced a measure called the Protecting Patients from Surprise Medical Bills Act.<\/a> These efforts aim to limit how much a patient must pay out-of-network doctors, specify how much the insurer has to pay out-of-network doctors or both. Such efforts will certainly help.<\/p>\r\n\r\n\r\n\r\n

Here\u2019s an idea:<\/h3>\r\n\r\n\r\n\r\n

Combine the payments to the physicians and the payment for the rest of the care into a single payment. There is a need to help eliminate surprise bills by passing legislation mandating that Medicare combine physician payments with other payments.\u00a0 A single payment for care will decrease paperwork and increase price transparency. Equally important, it will protect patients from the often catastrophic financial damage of surprise bills. It is the right thing to do for more reasons than one.<\/p>\r\n\r\n\r\n\r\n

The 6-point proposal<\/h2>\r\n\r\n\r\n\r\n
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  1. Prohibit balance billing by barring providers from asking patients for payments for out-of-network emergency care;<\/li>\r\n
  2. Take patients out of insurer-provider billing disputes by requiring insurers to pay coinsurance, copayment, and deductible directly to the provider and collect any additional payments from the patient;<\/li>\r\n
  3. Ensure patients do not pay more out-of-pocket for out-of-network emergency care than they would pay for in-network care;<\/li>\r\n
  4. It requires insurers to convey plan details for members clearly;<\/li>\r\n
  5. It requires insurers to convey patients’ rights related to emergency care; and<\/li>\r\n
  6. We need to establish an arbitration process to settle network issues to exclude patients from billing disputes between insurers and providers.<\/li>\r\n<\/ol>\r\n\r\n\r\n\r\n

    How to work it out?<\/h3>\r\n\r\n\r\n\r\n