Washington state continues efforts to curb balance billing

Washington state continues to make efforts to pass new legislation protecting consumers from balance billing, according to a KGW report.

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

Balance billing may occur when a patient receives a bill for an episode of care previously believed to be in-network and therefore covered by the insurance company, or when an insurance company contributes less money than expected for a medical service.

Washington state's insurance commissioner, Mike Kreidler, proposed a bill to end balance billing last legislative session. He wanted lawmakers to pass HB2447, which would have required insurance companies and providers to resolve disputes about out-of-network fees through arbitration, according to the report.

However, his proposal failed after physicians, hospitals and insurance companies came out against the measure.

According to the report, medical providers and insurance companies were concerned arbitration and its related costs would be high and ultimately result in higher healthcare prices.

Now, Washington Rep. Eileen Cody (D-Seattle) is helping to lead negotiations already underway for a second attempt at new legislation. She argues balance billing shouldn't be legal in the case of emergency care, or when the patient isn't warned that a provider is out of network, according to KGW.

Rep. Cody said she is set on reaching a compromise all sides of the issue can live with, according to the report.


More articles on finance and revenue cycle management:

30 things to know about balance billing
Uncovering revenue sources through transformation of the hospital lab
Mississippi to close more than 30 psychiatric beds amid state budget cuts: 5 things to know


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