medical bills | Texas Public Radio

medical bills

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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.

  

In Texas, a growing number of patients are turning to a little-known state mediation program to deal with unexpected hospital bills.

The bills in question often arrive in patients' mailboxes with shocking balances that run into the tens or even hundreds of thousands of dollars.

When patients, through no fault of their own, are treated outside their insurers' network of hospitals, the result can be a surprise bill. Other times, insurers won't agree to pay what the hospital charges, and the patient is on the hook for the balance.

Steve Miller has some customers on offer. Millions of them in fact.

The chief medical officer at Express Scripts, the largest pharmacy benefit manager in the U.S., has been essentially auctioning off his 80 million customers to the drug companies that will give him the best deal.

"Who wants my market share?" Miller says. "Whoever will give me the best price, I will reward you with an enormous amount of market share."

Going to the Emergency Room in Texas and you should brace yourself for some surprises – even you have great insurance coverage. According to a new report Texans are Charged More Than 650% The Going Rate Of Medicare For ER  services. Jamie Dudensing is the CEO of the Texas Association of Health Plans.

Federal officials have spent years locked in a secret legal battle with UnitedHealth Group, the nation's biggest Medicare Advantage insurer, after a government audit detected widespread overbilling at one of the company's health plans, newly released records show.