Patients will no longer have to worry about getting a huge bill following a medical crisis if the closest hospital emergency room happened to have been outside their insurance plan’s provider network.
They’ll also be protected from unexpected charges if an out-of-network clinician takes part in a surgery or procedure conducted at an in-network hospital. In such situations, patients will be liable only for their in-network cost sharing amount.
The idea was to take patients and their families out of the financial equation by limiting what they can be billed for out-of-network services to a fee that’s based on in-network charges. That amount gets counted toward their in-network annual deductible.Chidiebere Ibe talks with FOX Television Stations about his medical illustrations showing Black skin and how he hopes this will improve education and health care access.
A key part of the new system spells out a resolution process that hospitals, doctors and insurers will use to haggle over fees, without dragging patients into it. The arbitrator will use as a guide a set amount intended to balance the value of the medical services provided with the goal of keeping costs from ballooning out of control. Clear justification will be required for the final payment to end up higher or lower.
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