7 must-reads on balance billing

With the rise of consumerism in healthcare, the industry and states are increasingly focused on the practice of balance billing.

Balance billing occurs when a medical provider charges an amount for their services, and the patient is responsible for costs not covered by insurance. It often happens when the provider is not part of the patient's insurance network, and leaves consumers with unexpected charges.

Here are seven articles published this year by Becker's Hospital Review offering insight on balance billing, including recent legislative actions and more.

1. Ban on air ambulance balance billing sought in Florida
Sha`Ron James, Florida's insurance consumer advocate, is calling for consumer balance billing protections for emergency medical transportation services such as ground and air ambulances.

2. Mississippi residents may have an out for surprise medical bills
A Mississippi law prohibiting balance billing could help patients reduce out-of-pocket healthcare costs. However, not all medical providers know about the legislation.

3. Sen. McCaskill drafts bill to give states more control over air ambulance costs
Sen. Claire McCaskill, D-Mo., drafted the Air Ambulance Consumer Protection Act May 10, which is designed to give states greater regulatory control over air ambulances.

4. HCA TriStar, BCBS dispute generates $14M in balance bills
A network dispute between Brentwood, Tenn.-based TriStar Health, a subsidiary of Nashville, Tenn.-based HCA Healthcare, and BlueCross BlueShield of Tennessee generated $14 million in balance bills.

5. Proposed Rhode Island legislation aims to address surprise medical bills
Rhode Island lawmakers introduced legislation to address balance billing in April. It applies to surprise bills for nonemergency medical services.

6. Oregon balance billing law takes effect
Oregon implemented balance billing legislation March 1. The legislation, House Bill 2339, passed the Oregon legislature last year. Under the legislation, healthcare providers are prohibited from charging patients out-of-network rates for care provided at in-network facilities.

7. New Jersey passes law fighting surprise medical billing: 8 things to know
New Jersey Gov. Phil Murphy signed legislation May 31 to combat surprise out-of-network medical expenses. The legislation, Assembly Bill No. 2039, addresses New Jersey's healthcare delivery system in terms of out-of-network billing and arbitration, as well as disclosure and transparency.

 

More articles on healthcare finance:

CMS boosting Medicaid audits, oversight to 'strengthen safety net'
National coalition of big businesses to form bundled payment network
Ban on air ambulance balance billing sought in Florida

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