There have been reports of consumers getting very large, unexpected medical bills despite the fact they have medical insurance. These bills are created when a patient, without their knowledge is treated by an “out of network” doctor. There is a proposed fix for the problem and we are asking for your help to get it passed.
Here is how the problem is created:
Your health insurance company has negotiated the price the insurance company will pay for sevices with hospitals and doctors. These doctors and hospitals are called “in network”.
Not all doctors providing services in the hospital are part of the same network. And in cases of emergency services and/or operations, even if the primary doctor is in network, other doctors providing services may not be.
The out of network doctors may refuse to accept the insurance company’s payment, instead billing the patient directly, some times for thousands of dollars.
After holding hearings, Pennsylvania Governor Tom Wolf is recommending new legislation, a change that will protects patients from surprise bills.
The proposed law would stop consumers from being charged more than their deductible and allow doctors who are out of network to negotiate a fair payment and if not successful use arbitration to arrive at an equitable agreement.
We are asking you to support this consumer protection. No patient should be charged for bills they didn’t agree to. It is impossible to require a patient receiving emergency treatment or being operated upon to question everyone in the room if they are in their network or not.
Please use this link to contact the PA Insurance Department with your support.
And feel free to forward this email to anyone you think might be interested in helping to pass this important protection.
If you have a particular concern with regards to a medical bill, please contact me directly.
Together we will be able to make a difference.
Lance Haver is Director of Civic Engagement for Philadelphia City Council.
