A Small Step Forward on Surprise Medical Care “Balance-Billing”

13 Responses

1. Hope Hetico RN MHA, on February 2, 2017 at 7:57 PM said:

   AMA: Top 5 Medical Billing Denials

   1. Missing information
   2. Duplicate claim or service
   3. Service already adjudicated
   4. Not covered by the payer
   5. Limit for filing expired

   Source: Advance Web

   LikeLike
2. Gaby Witte, on May 9, 2019 at 4:13 PM said:

   Dear Dr. David,

   The Affordable Care Act made sure that no individual could be denied health coverage due to a pre-existing condition. Last fall, the Trump administration issued guidance that weakened this provision of the ACA. Fortunately, this afternoon the U.S. House of Representatives will consider legislation that would revoke the administration’s efforts to undermine these important protections.

   Contact your representative TODAY and urge them to vote yes on H.R. 986, the Protecting Americans with Pre-Existing Conditions Act of 2019! This is a critical step towards ensuring that all Americans have access to comprehensive, affordable health care.

   Sincerely,
   Gaby Witte
   Senior Manager of Government Relations
   APHA

   LikeLike
3. Dr. David E. Marcinko MBA, on May 10, 2019 at 1:02 AM said:

   Balance Billing

   What It Is and Why Trump Wants to Get Rid of It?
   https://news.yahoo.com/balance-billing-why-trump-wants-183852980.html

   Dr. David E. Marcinko

   LikeLike
4. Dr. David E. Marcinko MBA, on August 19, 2019 at 6:05 PM said:

   42.8% of ED Admissions in 2016 Incurred Out-of-Network Charges

   JAMA Internal Medicine recently published research on out-of-network charges for hospital inpatient and emergency department (ED) admissions. Here are some key findings:

   • From 2010-2016, out-of-network billing increased from 32.3% to 42.8% of ED visits.
   • The mean potential liability to ED patients increased from $220 to $628 from 2010-2016.
   • For inpatient admissions, the incidence of out-of-network billing increased from 26.3% to 42.0%.
   • The mean potential liability to patients increased from $804 to $2040 for inpatient admissions.

   Source: JAMA Internal Medicine, August 12, 2019

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5. Dr. David E. Marcinko MBA, on September 11, 2019 at 2:34 AM said:

   Update on BB
   [AKA surprise billing]

   https://www.modernhealthcare.com/patients/surprise-medical-bills-becoming-more-frequent-and-costly

   Dr. David E. Marcinko MBA

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6. Dr. David E. Marcinko MBA, on October 30, 2019 at 10:46 PM said:

   MORE on BB

   https://khn.org/news/investors-deep-pocket-push-to-defend-surprise-medical-bills/

   Dr. David E. Marcinko MBA

   LikeLike
7. Dr. David E. Marcinko MBA, on December 11, 2019 at 10:02 PM said:

   UPDATE

   http://www.msn.com/en-us/money/healthcare/patients-insurers-seen-as-biggest-winners-in-surprise-medical-bill-deal/ar-AAK1rbL?li=BBnb7Kz

   Dr. David E. Marcinko MBA

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8. Dirk, on December 23, 2019 at 7:10 PM said:

   12.3% of Pathologist Care at In-Network Hospitals Was Billed Out-of-Network

   Health Affairs recently published an article on out-of-network billing among specialists at in-network hospitals for a large commercial insurer. Here are some key findings from the report:

   • At in-network hospitals, 11.8% of anesthesiology care was billed out-of-network in 2015.
   • 12.3% of care involving a pathologist was billed out-of-network in 2015.
   • For radiologists, 5.6% of claims at in-network hospitals was billed out-of-network in 2015.
   • 11.3% of cases involving an assistant surgeon were billed out-of-network in 2015.

   Source: Health Affairs, December 16, 2019

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9. Dr. George, on June 25, 2020 at 9:49 PM said:

   CMS

   CMS has announced today that providers should continue to use the current ABN despite the March 2020 expiration. A new form is currently awaiting approval and should be released later this summer, which should be good for 3 years.

   Dr. George

   LikeLike
10. Dr. George, on December 15, 2020 at 7:18 PM said:

    2 in 3 Privately Insured Adults Have Received an Unexpected Medical Bill

    The American Heart Association recently released survey results on unexpected medical bills. Here are some key findings from the report:

    • Half of U.S. adults say worrying about an unexpected medical bill keeps them from seeking care.
    • 44% say they would not have the money for an unexpected medical bill for $1,000.
    • 2 in 3 U.S. adults with private health insurance have received an unexpected medical bill.
    • Of those, 33% were not able to pay the bill with money immediately available to them.
    
    Source: American Heart Association, November 30, 2020

    LikeLike
11. Jeremy, on December 17, 2020 at 4:05 PM said:

    Surprise Corona Vaccine Bills?
    https://www.fromhealthnews.com/2020/12/17/the-vaccines-are-supposed-to-be-free-surprise-bills-could-happen-anyway/
    Jeremy

    LikeLike
12. Gaby, on July 4, 2021 at 4:02 PM said:

    Air Bills

    https://www.msn.com/en-us/news/politics/unexpected-dollar36k-air-ambulance-bills-expected-to-be-history-under-new-surprise-billing-rule/ar-AALKX8s?li=BBnb7Kz

    Gaby

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13. Dr. David E. Marcinko MBA, on July 18, 2021 at 3:23 AM said:

    BBing – The Next Generation?

    Hospitals charge huge ‘trauma’ fees to treat people with minor injuries.
    https://www.msn.com/en-us/news/us/hospitals-charge-huge-trauma-fees-to-treat-people-with-minor-injuries/ar-AAMe1YN?li=BBnb7Kz

    Dr. David E. Marcinko MBA

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