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Fri Sep 13, 2019, 08:20 AM

Virginia hospitals oppose plan to stop some surprise medical bills

At this point, most people have either gotten stuck with a surprise medical bill they thought would be covered by their health insurance or know someone who has.

And during a two-and-a-half-hour hearing on the issue before the State Corporation Commission on Thursday, Judge Mark Christie made clear he falls firmly within the latter category.

Christie — one of three commissioners who will decide whether the state will adopt new regulations requiring hospitals to notify patients in advance if they’re likely to be treated by an out-of-network provider — repeatedly returned to the experience of a man he knows whose wife needed surgery.

As Christie tells it, the man, aware of the growing problem of surprise bills, called the hospital in advance to make sure the surgeon and anesthesiologist would be covered by his wife’s insurance.

Read more: https://www.virginiamercury.com/2019/09/13/virginia-hospitals-oppose-plan-to-stop-some-surprise-medical-bills/

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Reply Virginia hospitals oppose plan to stop some surprise medical bills (Original post)
TexasTowelie Sep 13 OP
Phoenix61 Sep 13 #1
Hoyt Sep 13 #2
Backseat Driver Sep 13 #3
The Genealogist Sep 13 #4

Response to TexasTowelie (Original post)

Fri Sep 13, 2019, 08:39 AM

1. This is the biggest reason to have

Medicare for all. The same thing happens in an emergency situation. What are you supposed to do then?

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Response to TexasTowelie (Original post)

Fri Sep 13, 2019, 08:42 AM

2. Hospitals and physicians could stop "surprise medical bills" today, if they wanted.

Hospitals could tell the out-of-network physicians/providers that they will not accept them on staff if they do not agree to take the insurance allowable (that all in-network physicians accept). Physicians could tell those they refer to that they will not get future referrals.

It's really that simple.

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Response to TexasTowelie (Original post)

Fri Sep 13, 2019, 08:55 AM

3. Yup, I've been subject to this deceptive practice

at the "1st responder"physician group practice level. When my insurance changed, I called to ask if the doc and practice took my insurance; yes, they did, but I did not ask the right question and, therefore, got the deceptive answer. Indeed they did take X company insurance--just not that company's plan under ACA. When I confronted a "surprise" bill, I proceeded to fire that doctor. Was doc concerned that the scripts prescribed would continue uninterrrupted by a change in the venue -- nope! Never heard from doc again for any reason.

After some research, my popular-with-family-and-friends doc had also been accepting additional income derived from the number of scripts prescribed for patients, for me!--to be fair, these were very typical but high-cost medications "appropriate" for the diagnosis.
More research yielded an even greater surprise -- those drugs would never cure, just alleviate the symptoms with side effects of their own, though a few lifestyle changes could bring better health to this patient. I implemented those instead and effectively controlled the major diagnosis out of existence.

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Response to Backseat Driver (Reply #3)

Fri Sep 13, 2019, 09:13 AM

4. Not cool of them at all

I worked in a PCP office for several years, and when a patient called in we always made sure to tell them to verify with their insurance if the provider was in network. Being part of a larger system, our office did not know if each plan would be in network, even of the patient's insurance company was in network. A lot of it came down to employer choices and what insurance product the patiemt chose. The office that saw you should have offered better customer service.

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