Arguably one of the biggest issues Texas lawmakers tackled this session was surprise billing, as they vowed to protect patients from receiving medical bills for care not covered by insurance.
Every day, patients pay a hefty price for their health care, and many are quick to blame rising costs and climbing insurance premiums on the first person that comes to mind: usually the “well-paid physician.”
Don’t let your patients place blame on you unfairly.
Although Blue Cross and Blue Shield of Texas (BCBSTX) places limits on the additional fees participating network physicians can charge BCBSTX patients, some are allowed when you provide concierge services.
When insurance companies say "no" — whether through prior authorization requirements, step therapy programs, or nonmedical switching policies — covered patients find … well … they don't have the coverage they need. A new survey finds this "hidden health care crisis" hits tens of millions of Americans.
As a result of recent changes in federal regulations, short-term health insurance plans aren’t so “short” anymore.
Traditionally, short-term plans were meant to act as stop-gap coverage for 30 to 60 days, and were usually purchased by workers between jobs. Now short-term plans can be sold for up to 364 days, and can be renewed for up to 36 months.
Protect Patients From Inadequate, Narrow Networks(TMA Testimony on SB 1264 by Jason Terk, MD)
Expand Access to Care to All Texans Who Need It(TMA Testimony by Doug Curran, MD, March 5, 2019)
Free Market Insurance Solutions Must Protect Texans(Hearing to Review Interim Charge 2: Health Insurance Market Stability Testimony by Ray Callas, MD, Jan. 24, 2018)
Information Accuracy and Oversight Will Minimize Surprise Billing(Testimony on Interim Charge by Ray Callas, MD, Jan. 23, 2018)
TMA Asks Legislators to Make Sure New Step Therapy Law Works(Testimony on Interim Charge No. 6 by Arlo Weltge, MD, Dec. 6, 2017)
Understanding Limitations on Price Transparency(Interim Hearing on Data Collection and Price Transparency by David Bryant, MD, March 21, 2017)
Ban Virtual Credit Cards
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Clean Claims 101: Read and Follow the Instructions
Claims Workflow Assistant from AMA
Coverage Coordination Through Availity
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Second-Tier Claims Resolution Unit Can Help UnitedHealthcare Participants
Take Action on Stale Clean Claims
Monitoring the contracted rate in your payer contracts is an important step in managing your revenue cycle. Are you receiving the full payment due to your practice for every claim you file?
Physicians have received more than 2 billion dollars in benefits from the settlement agreements reached with Aetna, CIGNA, Health Net, Humana, Anthem/WellPoint, and many Blue Cross and Blue Shield Plans as a result of class action lawsuits brought against these insurers by 19 state and county medical associations and physician representatives.
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