Surprise Medical Bills

Surprise Medical Bills

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Is healthcare a commodity or is healthcare a right? The truth is healthcare is both, it just depends on who you speak to. The older people can view health care as a right because they have earned the privileges through their labor. However, younger people do not get sick often so healthcare to them could be considered more of a commodity. No matter what category one falls under, Texas wants to protect all their citizens from ever receiving a surprise medical bill. Senate Bill 1264 protects patients from receiving large bills when they do not have a choice of provider, it assigns the Texas Department of Licensing and Regulation to handle complaints, and it sets up codes for insurance providers to follow.

Not having a choice of medical providers happens more often than not. Although people try to control as many aspects of their lives, an emergency room visit is inevitable. When this happens an individual does not have the power to choose a medical provider and this can result in a very high bill. The Affordable Care Act was passed in 2010 and it called for an individual mandate that demanded everyone maintain a minimum level of health insurance coverage. The health insurance companies created networks with health care providers that agreed to offer them the best care at a fixed rate. When establishments are not within the networks already created, bills can be higher and more costly. This is why patients are strongly urged to seek care at in-network health providers rather than the most convenient.

The Texas Department of Licensing and Regulation is in charge of oversight for many businesses. Although they do not specialize in health care specifically, they are responsible for the health and safety of all Texans. TDLR ensures that patients are being cared for by qualified professionals and are uniquely equipped to handle excessive health care bills and determine what options available are. The main TDLR office is located in Austin, Texas but anyone can get in touch by logging in to their website https://www.tdlr.texas.gov/ or calling them at (512) 463-6599. Filing a complaint can be done online or by the phone. TDLR will conduct their own investigation and determine the reasonable steps to follow.

All insurance providers have their own standard procedures to fulfill billing statements but Senate Bill 1264 provides all of them a uniform set of codes and conducts. One of these responsibilities is to honor the prices that a health insurance companies have set for their insured. If a doctor’s visit has a copay of $25, the health care providers cannot charge more than that. After the initial copay is paid, it is up to physicians and health insurance companies to resolve the payment disputes. This keeps patients out of the war zone without jeopardizing their health and safety. When their health and safety is at stake, that is when the bigger issues come to play.

Senate Bill 1264 is a valuable protection that is offered by the state. Without this law in place, physicians and medical establishments could be sending out medical bills that people would be unable to pay in full. It is important to consider what kind of coverage one is getting and how much that impacts the kind of care a person is being provided. If you receive an unexpected medical bill and your insurance company will not cover it, or has no knowledge of it, follow up with the medical center the patient received treatment. If the establishment is not willing to cooperate with you or your insurance, they may be in violation of Senate Bill 1264.

If you’ve been injured and received unexpected medical bills, a personal injury lawyer in Arlington, TX may be able to help you get the compensation you need. Call a law office today.

 


 

Thanks to Brandy Austin Law Firm, PLLC for their insight into personal injuries and surprise medical bills.

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