In mediation, doctors reduce billed charges by millions

February 27 09:12 2018 by ushadmin

Of $7 million in surprise medical bills settled through Texas’ mediation process last year, insurers increased their payments by $1 million, according to new state data.

That means physicians apparently made the more dramatic concession, reducing their payment demands by $6 million.

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The who-pays-what argument is at the core of an ongoing state crisis over a confusing medical business practice called balance billing that costs patients millions of dollars each year. Under the system, a doctor who is outside a patient’s insurance network can charge more and then shift any or all of the “balance” not paid by the insurer onto patients.

Last year, Gov. Greg Abbott signed into law a revised version of the state’s mediation process designed to give such patients a chance for relief. Those who feel wronged by a balance bill of more than $500 can request that their insurer organize a telephone conference between the insurance company and the physician to see if a compromise can be reached. If not, the dispute goes to a full hearing.

The law, which went into effect Jan. 1, expands the scope of mediation to now also include bills from free-standing emergency centers.

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On Tuesday, the state Senate Committee on Business and Commerce met at the University of Houston for a status check on the process…