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Texas Cracks Down On Surprise Medical Billing

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Four in 10 insured American adults say they have dealt with an unexpected medical bill.

Many were shocked to find out they owed thousands of dollars after receiving care at a facility or from a provider they assumed was in-network.

 

Why is there so much confusion and what's being done to make the process more transparent?

Being able to afford medical expenses is a top concern for two-thirds of Americans, as out-of-network costs and surprise medical bills affect more households.

In its examination of surprise medical bills, the Kaiser Family Foundation found that emergency care visits were more likely to result in at least one out-of-network charge in Texas, New Mexico, New York, California and Kansas.

 

These unexpected expenses are the result of balance billing – the difference between what the insurance plan will cover for out-of-network care and the estimated amount of services received.

What steps can you take to avoid surprise medical bills? What should patients know ahead of time? What resources are available for recipients of unexpected medical expenses?

 

 

What legal steps have been taken to combat surprise medical billing? How can medical professionals, hospital administrations and insurance companies improve the status quo?

 

Guests:

"The Source" is a live call-in program airing Mondays through Thursdays from 12-1 p.m. Leave a message before the program at (210) 615-8982. During the live show, call 210-614-8980, email thesource@tpr.org or tweet at @TPRSource. 

 

*This interview was recorded on Wednesday, July 10. 

 

Kim Johnson is the producer for Texas Public Radio’s live, call-in show The Source. She is a Trinity University alum with bachelor’s degrees in Communication and Spanish, and a Master of Arts Degree from the School of Journalism at the University of Texas at Austin.