The Texas Medical Association's dedicated task force on balance billing has issued a set of recommendations to curb balance billing practices in the state, reports Dallas Fort Worth Daily.
The association made the following recommendations to state legislators as they consider new balance billing legislation in the upcoming session:
- Increase state oversight to ensure the adequacy of insurer networks.
- Expand the current mediation process to include all out-of-network physicians and healthcare providers involved in the dispute.
- Expand the current mediation process to include out-of-network hospitals, ambulatory surgical centers, outpatient clinics, freestanding emergency medical clinics and ground ambulance services.
- Require insurers notify patients of the network status of facility-based physicians prior to elective, pre-authorized services.
- Impose a standard form physicians and providers can supply to patients that details which physicians may be involved in their care and how to contact them.
- Require insurance agents educate consumers about out-of-pocket expenses and inherent limitations in the plans they purchase.
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