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. And too often health insurers’ plans have narrow networks (when they do not include enough physicians in their networks), or unexpected limits on what they pay for out-of-network care. When those things happen the insurer pays less of the bill, meaning you, the policyholder and patient, pay more.
Physicians don’t like surprise medical bills either, and we empathize with our patients. We recognize this is a problem, which is why TMA convened a Special Task Force on Balance Billing that studied the causes and prescribed a plan to stop surprise bills. That prescription looks in all directions for solutions to this problem.
Latest News About Surprise Billing
Doctors understand it’s frustrating to have health insurance coverage but still receive unexpected medical bills. Watch this video to learn about Stanley and the surprise medical bills he received… and learn why he received them.
TMA has developed a one-page patient handout describing the most common reasons for "surprise" medical bills, and a longer document with more details.
The surprise bill problem has many causes, so the TMA Task Force on Balance Billing studied the causes and prescribed a plan to stop surprise bills.
Download TMA's Surprise Bill Prescription
Health insurance companies' use of narrow networks and unexpected limits on how they pay for services out of network are leaving Texans with medical bills they didn't expect. This comprehensive TMA white paper explores "How Health Insurance Company Practices Leave You Without the Coverage You Thought You Bought." Written for journalists, lay-people and policymakers, this easy-to-follow guide connects the dots between insurance company business practices and patients' surprise bills.