How to do away with those nasty surprise medical bills that a patient receives when he or she is discharged from the hospital — a sticker shock known as balance billing — continues to dominate the healthcare news cycle, as more solutions are offered.
Balance billing occurs when a hospital bills a patient for the services and procedures that are not fully covered by the patient’s health insurance. In most cases, it is a result of some portion of the services or procedures, or the doctors who performed them, not being part of the insurance company’s network. There have been a number of reports recently of individuals who have received life-saving treatment only to leave the hospital with tens of thousands of dollars in medical debts. In many cases, patients are not in a position to be concerned with price or cost while fighting for their lives.
There really only are two options, though — either someone other than the patient has to pay the difference or the hospital has to lowers what it is charging — and neither option appears to be a viable solution. The biggest stumbling block is deciding on what the “right price” for services is. Hospitals often use different pricing matrixes, based on whether an insurance company is paying the bill or whether the individual is paying. Understanding exactly how much a medical procedure costs can be the first step forward in ending balance billing, according to a published report.
A bill has been introduced in the Senate, for example, which would force insurance companies to cover any unpaid balance, which could then be passed on to individuals in the form of higher health insurance premiums.
