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No More Surprise Medical Bills: The New Billing System Is Complicated, But As A Patient, It Isn’t Your Problem


Even before the COVID-19 pandemic started, the cost of healthcare in the United States was financially ruinous for most Americans.  Having health insurance coverage could usually protect you from having to pay hundreds of dollars for a routine doctor’s office visit, but the burden was on patients to find doctors that accepted their insurance.  For many patients, that meant searching the insurance company’s physician directory and then calling doctor’s offices to verify that they still accepted the patient’s insurance plan.  By the time you found a doctor that took your insurance, you often had to drive a long distance to see that doctor or wait months for an appointment, but at least you knew beforehand how much you would need to pay.  Of course, if you needed emergency medical care, all bets were off, and you could get several bills, each asking you to pay hundreds of dollars or more for a single visit.  The federal government has ordered healthcare providers to stop sending surprise medical bills by January 1, 2022.  Meanwhile, if you are struggling with medical debt, contact a Miami debt lawyer.

When Out-of-Network Physicians Treat Patients at In-Network Hospitals

Under the old system, millions of patients suffered financial hardship because of a loophole involving emergency treatment for patients with health insurance.  In a medical emergency, the ambulance or helicopter takes you to the nearest hospital equipped to deal with your health crisis, and the doctors focus on stabilizing your health; insurance coverage is the farthest thing from anyone’s mind until the bills start arriving.  Insurance companies are not supposed to deny emergency room visit claims because the hospital isn’t in their network; an emergency is an emergency.  The trouble is that doctors, radiologists, and anesthesiologists who work in hospitals do not always accept the same health insurance plans that the hospitals accept. If you had surgery at an in-network hospital with an in-network surgeon, you might still get an unaffordable bill from an out-of-network anesthesiologist.

Under the new rules, out-of-network doctors who treat patients in an emergency setting cannot charge patients more than they would have had to pay if the doctor had been in-network.  As for where the doctors will get the rest of the money, it’s a little more complicated.  Doctors and insurance companies will go through a dispute resolution process to decide who pays how much.  So far, 50 organizations have signed up to act as arbitrators for this process.  The good news is that, no matter how much or how little money an out-of-network doctor receives for treating you, you will not have to pay anything more than your health insurance policy says you must pay.

Good Riddance to Surprise Medical Bills

If surprise medical bills from years ago are continuing to wreak havoc on your finances, a Miami-Dade County bankruptcy, credit repair, and debt lawyer can help you decide whether the best solution is bankruptcy, debt consolidation, or some other solution.  Contact Nowack & Olson, PLLC to discuss your case.



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