Commercial Insurance

  • Help Eliminate Patients’ Insurance Confusion

    Educating patient on 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.

    Help Patients Navigate Insurance Coverage  
  • Charging Concierge Fees to BCBSTX Patients

    HEDIS  

    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.

    Get More Information  
  • The “Hidden Crisis” of Coverage Denials

    Coverage Denials  

    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.

    Learn More About the Coverage Denial Crisis  
  • Do You Know the Hidden Costs of Short-Term Health Insurance?

     

    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. 

    Learn About Hidden Costs  
  • TMA Advocacy and Communications

    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

    ACA Exchange Plans: Q&A for Texas Physicians - Updated December 2015 MembersOnlyRed

    Physicians Prepare for Round Two of the ACA Marketplace

    TMA Healthy Vision 2020: Establish Fair and Transparent Insurance Markets 

    TMA Develops Tooklit to Help You Challenge Unfair Rankings

  • Current Health Insurance Articles

    Get the latest news on health insurance from TMA.

     

    View Article List

    Health Insurance Key Issues

    See TMA's plan of attack, an interview with TDI's newest boss, and how TMA is keeping insurers honest.

    View Article List
  • Contracts

    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?

  • RICO Settlements

    Alt Tag  

    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.

    See How Physicians Have Benefited  
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    TMA is helping to strengthen your practice by offering personal advice and creating a climate of medical success across the state. 

  • What could a TMA membership mean for you, your practice, and your patients?