Healthcare Industry News > A reason for health care reform

A Reason for Health Care Reform

Balance billing has become a significant problem for residents of Marin County in California. The term refers to patients who have health insurance but who are being billed for an amount above and beyond the amount covered by their policy.  Unlike co-insurance which involves an insurance provider and a consumer sharing the costs of medical treatment, these bills are being received by consumers who believed they already covered their portion of costs.

A recent study of balance billing found that 1.76 million insured California residents who went to the emergency room ended up receiving these bills.  The average cost was $300.  More than half of those billed ended up paying them.  Those who protested the bills ended up having the charges turned over to collection agencies.

Doctors and medical providers argue that balance billing is a necessity because insurance providers are paying too little in compensation to them.   Insurance companies claim the doctors and medical providers are charging them and their patients too much.  A new rule is being considered in California that would end the process.  When doctors or medical providers do not have a contract, they would be paid 150% of the Medicare rate.  The doctors claim that amount would still be insufficient.

Read Original Story on www.marinij.com 

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