Currently, a bill from an out-of-network emergency department physician, anesthesiologist, radiologist or pathologist must exceed $1,000 before the Texas Department of Insurance can get involved. Under the new law, hospital bills must exceed $500.
Texas Sen. Kelly Hancock (R) sponsored the legislation, which was approved by the Texas Senate Business and Commerce Committee in March.
The elimination of the $1,000 threshold for claims eligible for mediation would benefit patients like Mike Fryar of Grapevine, Texas, according to the report. In 2014, Mr. Fryar had an emergency appendectomy at a hospital covered by his health insurance plan but received a bill for $947 by an out-of-network physician assigned to his case.
“I ended up paying the entire amount to a doctor who did not see me in person,” said Mr. Friar. “My images were sent to his office for consultation without my knowledge[…] so I owed the debt.”
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