New Ban on Surprise Medical Bills
New Ban on Surprise Medical Bills
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New Ban on Surprise Medical Bills
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If you have a medical emergency, you will no longer need to worry about a large bill from a doctor you did not choose. 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. 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 from Louisiana, who was part of a bipartisan group of lawmakers who wrote the bill. He said he counted the bill as among his top achievements as a lawmaker.
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If you are having a medical emergency and go to an urgent care center or emergency room, you can't be charged more than the cost sharing you are accustomed to for in-network services. This is where the law's protections are the simplest and the most clear for people with health insurance. You will still be responsible for things like a deductible or a co-payment. But once patients make that normal payment, they should expect no more bills.
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Several studies found that around 20 percent of U.S. patients who had emergency care were treated by someone outside of their insurance network, including emergency room doctors, radiologists or laboratories. Any of those providers could send patients an extra bill after the fact, and some medical groups did so routinely. Such bills are now illegal.
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For scheduled services, like knee operations, C-sections or colonoscopies, it's important you choose a facility and a main doctor that is in your insurance plan's network. If you do that, the law bars anyone else who treats you from sending you a surprise bill. This also addresses a large problem. Surprise bills from anesthesiologists, radiologists, pathologists, assistant surgeons and laboratories were common before.
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If you have a medical emergency, you will no longer need to worry about a large bill from a doctor you did not choose.
...
If you are having a medical emergency and go to an urgent care center or emergency room, you can't be charged more than the cost sharing you are accustomed to for in-network services. This is where the law's protections are the simplest and the most clear for people with health insurance.
...
Several studies found that around 20 percent of U.S. patients who had emergency care were treated by someone outside of their insurance network, including emergency room doctors, radiologists or laboratories. Any of those providers could send patients an extra bill after the fact, and some medical groups did so routinely. Such bills are now illegal.
...
For scheduled services, like knee operations, C-sections or colonoscopies, it's important you choose a facility and a main doctor that is in your insurance plan's network. If you do that, the law bars anyone else who treats you from sending you a surprise bill. This also addresses a large problem. Surprise bills from anesthesiologists, radiologists, pathologists, assistant surgeons and laboratories were common before.
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Replies:
@EddyFree : Texas already has this in place but they've already found out how to skirt it. They'll skirt this too. Insurance and healthcare billing is the biggest fraud in this country.
Well the $1,153 bill I got in the mail last week for when my 17 yr son swallowed a sodacan tab last month surprised me.
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I wish we could have one bill for everything. For example, I have a baby. Hospital gives me the quote for a non-complicated delivery in advance. This quote would include everything related to a 2 day stay for uncomplicated delivery. I was shocked when I delivered our first baby 30 years ago. Fortunately, I had not had any health problems so I didn't expect to receive so many bills from so many providers. We paid them all promptly since we had planned & saved, but I just was surprised at how many different bills that we received.
Insurance and healthcare billing is the biggest fraud in this country.
@EddyFree : This is awesome and it's way past time.
@ParksideRes : What do you mean Texas has found ways to skirt this? I really hope that's not the case since I am about to have some major surgery and it's going to be expensive enough without any surprise medical out of network bills.
ParksideRes : That's why we need "Single-Payer".....
@M1cha3lo0o : Yikes! Yes I remember that little incident.
10 + years later, I'm still sending a check for $1.50 to the ambulance company who drove me from one hospital ER to the one right across the street. I could've walked, but they wouldn't let me. Tired of fighting them, so I'm just sending the $1.50 per month. The invoice, return envelope, and stamp certainly must cost more than $1.50. They haven't touched my credit. I'll be dead before this bill is paid off.
Well the $1,153 bill I got in the mail last week for when my 17 yr son swallowed a sodacan tab last month surprised me. ðŸ˜ðŸ˜“
I had my gallbladder removed in 1993. A few weeks later I receive a $700 bill from a doctor who observed the surgery.
This is good - don't know if it will fix anything - but it is worth a try. (at face value)
@RajunCajun : I have had no problems with c Medicare. I've been on it for 10 years.
ParksideRes : What do you mean Texas has found ways to skirt this? I really hope that's not the case since I am about to have some major surgery and it's going to be expensive enough without any surprise medical out of network bills.
I really have to disagree with you on that. Insurance is a mess but our government would screw things up even worse.
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