Insurance

  • Legislative Hotline: Insurance Bills In the Spotlight Today

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    Today is the 128th day of this session. In the waning days of this session, it is important to remember that it is much easier to stop a bill than to pass one, and frequently bills pass incrementally over several sessions.

    All of This and More  
  • TMA Pushes for Prior Authorization Limits, Clarity

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    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.

    Enough of the Roadblocks, Hassles, and Delays in Care  
  • Where Do We Go From Here With Our Health Care System?

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    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.

    Realities That Doomed the ACA From the Start  
  • TMA's Hassle Factor Log  

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    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.

    Get Help Getting Paid  
  • Insurance Articles

    You CAN Negotiate a Health Plan Contract

    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.

    Get the Terms and Fees You Want
  • Nationwide Credentialing 

     

     

    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.

    More About Nationwide Credentialing  
  • Beyond the Slogan “Medicare for All”

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    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.”

    What Does "Medicare For All" Really Mean?  
  • Help Eliminate Patients’ Insurance Confusion

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    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
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  • Healthy Vision 2025’s Plan to Hold Insurance Companies Accountable for What They Sell

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    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.

    TMA Pushing to Hold
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  • More Than 1 Million More Texans Could Be Covered, Report Shows

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    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.

    More on Medicaid Coverage Under ACA  
  • Medicare Enrollment Application Revised

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    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.

    Get the Details  
  • Texas' High Rate of Uninsured Hurting the Economy, Study Says

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    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.

    Details of What the Study Found  
  • Don’t Fall for Credentialing Scam, Blue Cross Says

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    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.

    Get the Scoop  
  • Blue Cross HMO Emergency Payment Review Policy Begins

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    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.

    TMA Is Disappointed  
  • U.S. Physicians Call Prior Authorizations An Overwhelming Burden

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    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.

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

  • TMA Insurance Trust  

     

     

    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

    More About TMAIT  
  • Reference-Based Pricing for Procedures Presents Possibility of Savings, Plenty of Questions

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    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.

    Read More  
  • Texas Medical Liability Trust 

     

     

    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

    More About TMLT  
  • TMA Legislative Testimonies

    Fix Surprise Billing and You’ll Fix the Need to Report Collections
    Jason Terk, MD on Senate Bill 1037
    April 23, 2019

    Medical Debt and Credit Reports
    David Bryant, MD on House Bill 2732
    April 16, 2019

    Transparency in Prior Auth and Physician Referrals
    John Flores, MD on House Bill 3828
    April 16, 2019

    Eliminate Prior Auth for In-Network Physicians
    John Flores, MD on House Bill 3232
    April 16, 2019

    Require Network Directory Accuracy
    John Carlo, MD,on Senate Bill 1742
    April 9, 2019

    Require Timely Updates to Network Directories
    John Scott, DO, on House Bill 1880
    April 9, 2019

    Protecting Patients From Balance Bills
    Ray Callas, MD, In SUPPORT of CSHB 2967 by Oliverson and CSHB 3933 by Martinez Fischer
    April 2, 2019

    Enforce Network Adequacy
    Ray Callas, MD In SUPPORT of HB 3911
    April 2, 2019

    Prohibit PA on Mandated Benefits
    Dr. Debra Patt, MD on House Bill 2408
    March 26, 2019

    Take Patients Out of the Middle of Balance Billing – The Right Way
    Dr. Ray Callas on House Bill 3933
    March 26, 2019

    Bring Transparency to Prior Authorization
    Dr. Doug Curran on House Bill 2327
    March 26, 2019

    Utilization Reviews Should Be Done by Texas-Licensed Physicians
    Dr. Doug Curran on House Bill 2387
    March 26, 2019

    Plans Should Inform Patients of Network Status When Requiring PA
    Dr. Debra Patt on House Bill 2520
    March 26, 2019

    Plan Directories Should Cross-Reference Physician Network Status
    Dr. Rick Snyder, MD on House Bill 2630
    March 26, 2019

    Prevent Non-Medical Switching by Plans
    Written Testimony on House Bill 2099
    March 26, 2019 

    Free Market Insurance Solutions Must Protect Texans
    Dr. Ray Callas, Hearing to Review Interim Charge 2: Health Insurance Market Stability,
    Jan. 24, 2018

    Information Accuracy and Oversight Will Minimize Surprise Billing
    Dr. Ray Callas, Testimony on Interim Charge
    Jan. 23, 2018

    TMA Asks Legislators to Make Sure New Step Therapy Law Works
    Dr. Arlo Weltge, Testimony on Interim Charge No. 6
    Dec. 6, 2017

    Understanding Limitations on Price Transparency
    Dr. David Bryant, Interim Hearing on Data Collection and Price Transparency
    March 21, 2017