<img height="1" width="1" src="https://www.facebook.com/tr?id=765055043683327&amp;ev=PageView &amp;noscript=1">
New call-to-action

Surprise Medical Billing Reaches a Tipping Point

David Rook

All across the country, a sweeping movement to combat surprise medical bills has been slowly percolating and is now finally gaining traction on a national level.

What began as grievances filed by wronged patients has grown into government officials at both the state and federal level championing legislation against this industry practice.

A law that recently went into effect in Arizona and recent remarks from President Trump are merely the latest in an ongoing trend that has the force to reshape how patients are billed for out-of-network expenses.

Unexpected Out-of-Network Charges Result in Surprise Medical Bills

Surprise medical billing isn’t so much an intentional practice of healthcare companies, as much as it’s a byproduct of the fractured healthcare industry. Specifically, it’s a result of multiple institutions and providers treating patients simultaneously while working for different employers.

In its simplest form, a surprise medical bill is an unexpected medical bill that patients receive for out-of-network services that they thought were in-network. The bill is sent after the services are provided, leaving patients with little recourse and high fees since out-of-network charges tend to be much higher than those in-network.

An all too common scenario shows how easy this can happen to patients. A patient goes to a hospital for a covered surgical procedure. They’ve done their research and have made sure that both the hospital and the surgeon’s practice are within their insurer’s network. In completing this due diligence, they then assume that the entire procedure will be covered as an in-network expense. Seems reasonable, right?

Read More
Topics: Cost Containment, Legislation, trends, Arizona, healthcare costs, Arizona Regulations

Related posts

Arizona’s New Mini-COBRA Requirements for Small Businesses (with Sample Notice & Side-by-Side Comparison Table)

Jeff Griffin

At the start of this calendar year, Arizona became the latest state to adopt a mini-COBRA law, which impacts small employers. The new law specifically applies to employer-sponsored medical plans issued or renewed on or after January 1, 2019. (Employers with plans that were issued or renewed prior to this date have a little more time to comply with the law.)

The law requires small employers – those that offer group health plans, including medical, dental and vision - to offer continuation coverage to eligible employees and qualified dependents who experience Qualifying Events that would typically result in a loss of coverage.

These events include such things as loss of employment (for reasons other than gross misconduct), divorce or separation from the covered employee, or death of the covered employee.

Employers impacted by this new legislation are those that have fewer than 20 employees for more than fifty percent of its typical business days during the prior calendar year.

Although the new mini-COBRA continuation coverage requirements are very similar to the Federal COBRA requirements that apply to larger employers, there are some key differences. We invite you to download our side-by-side comparison of COBRA and Arizona’s Mini-COBRA of how these requirements compare with one another.

Read More
Topics: Compliance, COBRA, Arizona Regulations

Related posts

Instant Blog Alerts

Straight to Your Inbox

Most Read

Posts by Topic

Expand all
Free_White_Paper_Employee_Benefits_Branding
Free_White_Paper_Private_Exchange_Employee_Benefits
Free_White_Paper_Employee_Benefits_Branding
Free_White_Paper_Employee_Benefits_Hospitality
Free_White_Paper_Improving_Employee_Benefits_Communications
Free_White_Paper_Employee_Benefits_Construction
Free_White_Paper_Employee_Benefits_Branding