After hearing story after story of delays and denials, the Texas Medical Association is pushing the Texas Legislature to sign off on measures that would significantly curb insurers’ ability to require prior authorization on needed care, as well as clarify for both physicians and patients what it means when prior authorization is required.
To say that Medicare works well, denies the fact that in many patients are no longer able to go to the doctor of their choice. In fact, even finding a doctor is difficult. Additionally, many doctors no longer participate in the Medicare program. This program is only one step away from a single payer health care system, which was once referred to as socialized medicine.
TMA’s Hassle Factor Log® helps you resolve insurance-related problems. TMA meets regularly with Medicare, Medicaid, health plans, and large insurers to discuss the specific problems that you bring to our attention.
Many physicians assume that attempting to negotiate a health plan contract is hopeless — but that is a myth. Survey data from TMA show that physicians’ negotiation attempts often are successful. Respondents report winning both payment and term changes in their contracts.
Credentialing with the government and health insurance companies continues to be a complex and time-consuming management function for practices of all sizes. At Nationwide Credentialing, we work with you from start to finish on the credentialing process, which allows physicians and their staff to focus on patients and other important aspects of their practice.
Medicare For All is becoming popular among Democratic lawmakers and the public. But, as popular as the concept is, the details are lost in the simple slogan of “Medicare for All.”
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.
The Texas Medical Association’s Healthy Vision 2025 – released this week – seeks to draw a roadmap for how legislators can hold insurance companies accountable for the products they sell to patients.
Expanding Medicaid coverage under the Affordable Care Act (ACA) would help put a substantial dent in the number of uninsured Texans, a new report by the Kaiser Family Foundation (KFF) shows.
A new Medicare enrollment application form for physicians and nonphysician practitioners will go into effect May 1.
The CMS-855I form, revised in December 2018, is available for use now. After April 30, Novitas Solutions and the other Medicare administrative contractors will accept only this new version.
Texas has the highest percentage and number of people without health insurance in the United States, which could cause long-term damage to the state’s economy, says a study released this week by the Texas Alliance for Health Care.
Blue Cross and Blue Shield of Texas (BCBSTX) warns physicians to be aware of a scammer that is offering to help doctors become credentialed with the insurance company for $250.
Blue Cross Blue and Shield of Texas will require some members to pay 100 percent of their medical bills if they go to an out-of-network emergency room for certain non-life-threatening conditions, company officials have confirmed.
A nationwide survey released this week by the American Medical Association documents the growing, negative effects insurance companies’ prior authorization demands have on patients’ health and physicians’ time.
TMAIT offers medical, life, income protection, office overhead, and ancillary insurance to TMA member physicians and their group managers. We work with you online, on the phone, or in person to determine the right plan to meet your current career needs. That’s coverage you can count on. Phone: (800) 880-8181
In reference pricing, a payer or employer sets a standard, maximum price that it will pay for a specific service or procedure. Patients are responsible for any costs above the reference price.
TMLT is a unique, not-for-profit health care liability claim trust owned by its physician policyholders, and is the only professional liability carrier exclusively endorsed by the Texas Medical Association. Created in 1979, TMLT has grown to be the largest medical liability provider in the state, protecting more than 14,500 Texas physicians. Phone: (800) 580-8658
Fix Surprise Billing and You’ll Fix the Need to Report CollectionsJason Terk, MD on Senate Bill 1037April 23, 2019
Medical Debt and Credit ReportsDavid Bryant, MD on House Bill 2732April 16, 2019
Transparency in Prior Auth and Physician ReferralsJohn Flores, MD on House Bill 3828April 16, 2019
Eliminate Prior Auth for In-Network PhysiciansJohn Flores, MD on House Bill 3232April 16, 2019
Require Network Directory AccuracyJohn Carlo, MD,on Senate Bill 1742 April 9, 2019
Require Timely Updates to Network DirectoriesJohn Scott, DO, on House Bill 1880 April 9, 2019
Protecting Patients From Balance BillsRay Callas, MD, In SUPPORT of CSHB 2967 by Oliverson and CSHB 3933 by Martinez Fischer April 2, 2019
Enforce Network AdequacyRay Callas, MD In SUPPORT of HB 3911 April 2, 2019
Prohibit PA on Mandated BenefitsDr. Debra Patt, MD on House Bill 2408 March 26, 2019
Take Patients Out of the Middle of Balance Billing – The Right WayDr. Ray Callas on House Bill 3933 March 26, 2019
Bring Transparency to Prior AuthorizationDr. Doug Curran on House Bill 2327 March 26, 2019
Utilization Reviews Should Be Done by Texas-Licensed PhysiciansDr. Doug Curran on House Bill 2387 March 26, 2019
Plans Should Inform Patients of Network Status When Requiring PADr. Debra Patt on House Bill 2520March 26, 2019
Plan Directories Should Cross-Reference Physician Network StatusDr. Rick Snyder, MD on House Bill 2630March 26, 2019
Prevent Non-Medical Switching by PlansWritten Testimony on House Bill 2099 March 26, 2019
Free Market Insurance Solutions Must Protect TexansDr. Ray Callas, Hearing to Review Interim Charge 2: Health Insurance Market Stability,Jan. 24, 2018
Information Accuracy and Oversight Will Minimize Surprise BillingDr. Ray Callas, Testimony on Interim ChargeJan. 23, 2018
TMA Asks Legislators to Make Sure New Step Therapy Law WorksDr. Arlo Weltge, Testimony on Interim Charge No. 6Dec. 6, 2017
Understanding Limitations on Price TransparencyDr. David Bryant, Interim Hearing on Data Collection and Price Transparency March 21, 2017
Some Texans receive medical bills they did not anticipate, even though they have health insurance. Their insurance might not cover that care or provide as much benefit as they assumed.
More On Surprise Bills
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