Law helps protect patients from surprise hospital bills

Law helps protect patients from surprise hospital bills
Balance billing is specifically targeted by the new law. (Source: kauz)

WICHITA FALLS, Texas (TNN) - Elyssa Bull did her best to make sure everything for a routine checkup was covered by her insurance.

“I called my health insurance I made sure everything was in check, I said this is what I want to do, this is who I’m going to go with this is the physician I’m going to choose,” she said.

When a bill came in a month later, it surprised her.

“So then I called my health insurance and they said ‘Oh well they ran the pathology and blood work through this clinic and unfortunately we don’t cover that,’” Bull said

Cases like that have become more common. That’s why Texas lawmakers passed SB 1264 which helps to stop surprise bills.

“Health care is the only thing that we buy, without knowing the cost going in,” health insurance specialist Kelly Fristoe said.

Fristoe says this law will help patients overall with more transparency from cost benchmarks and likely a reduction in insurance rates from fewer out of network bills.

This law doesn’t cover everyone with health insurance, only state-regulated plans which are marked with a T-D-I or D-O-I on the coverage card.

“There’s large employers, employers that may have 100, 200 maybe 400 or 500 employees and they’re not regulated by the state, they’re regulated outside of the state by a program called ERISA,” Fristoe said.

It has helped to lead the way for national legislation that would help those plans.

Along with President Trump pushing for more transparency in health care.

Rep. James Frank was one of the co-sponsors of this bill:

I was proud to vote in favor of SB 1264 during the previous session, and excited at this proactive step the Legislature took to protect patients. The bill provides common sense protections to patients and takes them out of surprise billing disputes between providers and insurance companies. Though there were bumps in the road on the way to the bill's implementation on January 1, I was pleased that the Texas Department of Insurance ended up writing rules that are in line with the Legislature's intentions to protect consumers and ensuring patients no longer have to worry about surprise medical bills.
Rep. James Frank (R-Wichita Falls)

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