Insurance

  • California Model Benefits Insurers, at Physicians’ and Patients’ Expense, Physicians Tell Congress

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    TMA physician leaders, along with their colleagues from California and the rest of the country, are on Capitol Hill this week, lobbying Congress to toss out a California-inspired provision from a rapidly moving health insurance bill.

    More About the "Median In-network Rate" Provision  
  • Arbitration Law Will be “Messy,” Bring Operational Concerns, Panelists Say

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    The state’s new law allowing arbitration of payment disputes on certain out-of-network care carries concerns for physicians and uncertainty about what it will look like from an enforcement standpoint, a panel told the Texas Medical Association Winter Conference on Saturday morning.

    New Arbitration Law is "Messy"  
  • Insurance Companies Have Denied My Doctor’s Orders, 25% of Texas Voters Say

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    One in four Texas voters say their health insurance company has refused to cover what their physician ordered for them or their families, a new statewide survey has found.

    Patients Suffer When Care Is Delayed or Denied  
  • State Adopts Emergency Rule on Surprise Billing Law

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    The Texas Department of Insurance (TDI) has adopted an emergency rule outlining the narrow circumstances when it will be legal for physicians to balance bill patients under the state’s new law that protects patients from surprise medical bills.

    Read the Details Here  
  • 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  
  • 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
  • You May Need to Refile Some Medicare Claims

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    Be on the lookout for Medicare claims you’ve filed since Oct. 1 in which procedure codes failed to process, causing a rejected claim. You will need to refile these claims.

    Get the Details
  • 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  
  • 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  
  • 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  
  • 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
     
  • 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  
  • 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
     
  • 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
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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  
  • 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