Proposed legislation targets surprise billing in Georgia: 4 things to know

Georgia lawmakers are proposing laws to deal with surprise billing, reports The Atlanta Journal-Constitution.

Here are four things to know.

1. The practice of surprise billing, also known as balance billing, refers to a physician's ability to bill patients for outstanding balances after the insurance company submits a portion of the bill. Out-of-network physicians, not bound by in-network rate agreements, may bill patients for the remaining balance.

2.  Out-of-network physicians claim they must bill patients because insurers do not pay them enough for their services, according to the report. Insurers, on the other hand, claim physicians are cashing in by surprise billing, the report states.

3. In Georgia, lawmakers are proposing legislation aimed at curbing surprise billing, particularly in the emergency room. Georgia, Rep. Richard Smith, R-Columbus, chairman of the House Insurance Committee, has proposed House Bill 71; in the Senate, Georgia Sen. Renee Unterman, R-Buford, chairwoman of the Health and Human Services Committee, is pushing Senate Bill 8, according to the report.

4. According to the report, both bills would mandate more openness with patients regarding what physicians will be participating in their care and what network physicians belong to. However, in both bills, much research regarding billing will be left to the patient. Also, neither bill would eliminate out-of-pocket costs like deductibles and co-pays.


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