Figuring out what hospital your insurance company will actually pay for is tough enough. But determining ahead of time which of the physicians that practice at said hospital are in-network with your carrier is almost cruel. This is how balance billing happens—those surprise medical bills show up separate from your insurance statement after receiving care in a hospital or a surgery center and stick you with the difference.
State Sen. Kelly Hancock, a Republican from Fort Worth, has filed a bill that gives more power to the consumer when these occur. D CEO’s Olivia Nguyen has more details over on our healthcare site, but the gist is this: The Texas Department of Insurance reports that complaints over balance billing has risen more than 1,000 percent in the state since 2012. Back then, the TDI logged a measly 112 complaints. In 2015, that number ascended to 1,334. Part of that came out of a law in the last session that gave patients the power of mediation if they disputed any charge greater than $500.
Hancock’s new bill opens that up to all out-of-network charges coming from hospitals that, for all intents and purposes, should’ve been part of a carrier’s network. All emergency facilities—like the freestanding ERs that now dot so many of our more affluent corners—would face mediation over the billing, and insurers would be required to boost disclosure requirements to their plan holders.
The goal of SB 507, clearly, is to empower the patient with transparency. We’ll see if it sticks.