Insurance

  • 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  
  • TMA Says “No” to Federal Scope Expansion Under President’s Medicare Executive Order

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    President Donald Trump’s recent executive order on Medicare includes scope-of-practice language that is raising concerns among Texas physicians – including the president of the Texas Medical Association.

    Read TMA's Concerns  
  • Fix Medicare Now, TMA Tells Feds

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    Unless the federal government increases physicians’ Medicare payments and overhauls Medicare’s hassle-laden Quality Payment Program (QPP), access to health care for millions of American seniors and people with disabilities “is at risk,” the Texas Medical Association told Centers for Medicare & Medicaid Services (CMS) Administrator Seema Verma.

    More on This Unsustainable Trend  
  • Send TMA Your Prior Auth Nightmare Stories

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    Arbitrary. Confusing. Frustrating. Never-ending. Maddening. Those are some of the terms we can actually print that describe physicians’ perceptions of insurance companies’ prior authorization requirements and approval processes.

    Your personal stories of patient harm due to prior authorization request delays or denials can give the Texas Medical Association the ammunition it needs to fight this problem. 

    Submit Your Story
  • 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
  • An Insurance Company Auditor Tried to Destroy My Career

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    It didn’t matter that the charges against me were ludicrous. The potential consequences were only too real, and potentially catastrophic. Had the State Medical Board decided against me, I could have lost my license. I hired a lawyer, sinking more than $8,000 into legal fees. I was cleared by a unanimous committee vote. But other physicians facing similar situations may not be as lucky.

    Caught in the Crosshairs of an Insurance Company Auditor  
  • Are You Eligible for “Expedited Credentialing?” 

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    If you’re completing health plan credentialing, “expedited credentialing” might apply to you. And if it applies, that could be good for you and your practice. 

    But how do you know if it does? 

    Get the Details  
  • Tying Immigration to Medicaid “Foolish," TMA President Says

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    The Trump Administration's new rule seeking to limit access to green cards for immigrants who receive Medicaid and other government benefits will discourage people from seeing their physicians, worsening medical problems and harming public health.

    This "Public Charge" Affects Patients, State and Society  
  • 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
     
  • Tell Congress: Protect Patients, Not Health Plans

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    Our U.S. senators and representatives are back home in Texas for the August recess, and Texas Medical Association President David Fleeger, MD, says their physician-constituents need to contact them to make sure they stop the surprise medical billing epidemic in a way that helps our patients – not big insurance companies.

    Spare Patients the Pain
    of Surprise Bills
     
  • Legislative Wins on Insurance

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    TMA went into this session looking to attack insurer network inadequacy and health plans’ use of care-impeding prior authorization demands.

    On both fronts, medicine scored solid legislative wins that will make it easier for patients and physicians to know who’s in network, and provide needed transparency on preauthorization requirements. And on surprise billing, medicine turned what could’ve been a disastrous bill into something more palatable.

    Charting Medicine’s
    Statehouse Progress: Insurance
     
  • Health Care is Difficult to Afford, More Than Half of Texans Say

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    Health care is the toughest living expense for most Texans to afford, and many skip or postpone tests, medications, and basic procedures because of the cost. And that very well could be bad for their health, especially for the millions who lack insurance. Those are the findings of a statewide poll on the affordability of and access to health care in Texas published last month by the Episcopal Health Foundation.

    Health Care Costs Too Much, Most Texans Say  
  • 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  
  • Panel Makes Big Change in Draft Federal Surprise Billing Law

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    Thanks to incessant lobbying from physicians, hospitals, organized medicine, and the Physicians Advocacy Institute, a key congressional committee today made significant revisions in a bill to reduce the strain of surprise billing on patients. “This certainly sounds like an improvement,” said Texas Medical Association President David Fleeger, MD, “but the devil will be in the details.”

    End Surprise Bills –
    The Right Way
     
  • Texas Physicians Weigh in on Federal Surprise Billing Solution

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    As Texas prepares to implement an arbitration process to address surprise medical bills, Texas physicians are helping the U.S. Congress work on a federal solution. The House Committee on Energy and Commerce’s Subcommittee on Health tackled surprise billing in a hearing last week to consider the No Surprises Act, draft legislation put together by two committee members.

    Pushing the No Surprise Bill
    at the Federal Level
     
  • 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  
  • Medicare Muzzle? New Rules May Make Physicians Reluctant to Speak Up 

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    New Medicare rules on local coverage determinations may make physicians reluctant to speak their minds.

    Get the Details  
  • 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  
  • 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
    Insurers Accountable
     
  • More Than 1 Million More Texans Could Be Covered, Report Shows

    Medicaid coverage  

    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  
  • 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 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