Patient claims medical billing practices

Patient claims medical billing practices
May 12 01:00 2016

Washington consumers have been gouged by unexpected medical bills despite going to a doctor or clinic in their insurer’s network, but Washington patients are not the only ones hit by a practice called balance billing.

States nationwide have experienced instances of balance billing and many report complaints are on the rise.

Currently, the Consumers Union estimates around 30 states are working on laws to protect consumers from these unexpected medical bills.

The organization credits about four with passing comprehensive legislation.

Congress is also considering legislation coined the “End Surprise Billing Act” is so important.

“It’s just overwhelming,” said Tiffany, who received a surprising medical bill after experiencing complications while she was giving birth to her daughter. “Compared to my salary, this bill is, I’d say, about three and half times more than I make annually.”

A Denver man named Dave was charged more than $3,500 by a hospital for 10 bags of saline.

“I don’t get understand, I don’t get it,” Dave said.

“This is crazy,” said Lisa, who received a bill for more than $1,000.

The charges were for special equipment used in her back surgery near Austin, Texas. Doctors hadn’t warned her they’d be using.

“Why didn’t you mention this to me when I called you months ago,” Lisa asked.

A man named James also received a surprising bill for roughly $4,200 near Phoenix, Arizona after rushing to the ER with violent stomach cramps.

“It’s just way out of my budget,” James said.

Around the country, the stories are mounting.

Balance Billing happens when a patient gets stuck in the middle of a reimbursement battle between an insurance company and a medical provider then winds up with the bill.

“It can be impossible or very difficult to avoid these bills even if you have done everything right,” said Stacey Pogue, consumer advocate with the Center for Public Policy Priorities in Texas.

Pogue says balance billing needs to stop.
“Enough saying that the problem is that the consumer is not educated enough about the healthcare system,” Pogue said. “When we have a system so complex that even experts can’t navigate it, it doesn’t make sense to turn around and blame the consumer.”

The Consumer’s Union estimates nearly one in three Americans with private health insurance have had a surprising medical bill in the past two years…

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