Surprise Medical Bill Laws: The Good, the Bad, and the Ugly Presented by Thomas LaGreca
Event Date: September 9th, 2021
This program is valid for 1 CHBME credit
As a result of patients facing substantial balance bills from out-of-network providers for emergency or inadvertent out-of-network services, states across the country, as well as the federal government, have enacted legislation addressing these “surprise medical bills.” The only thing they tend to have in common is their protections of the patient, whereby they seek to have the patient treated as if the services they received were in-network services. They have the overarching benefit to medical providers of removing the necessity of obtaining the health insurance plan of the patient, which can be more than challenging when the patient is seen in an emergent or inadvertent context. These laws vary widely, however, in terms of the standard and the mechanisms for reimbursing the out-of-network medical provider. Some are good; some are bad; some are ugly. This presentation focuses on which laws fall into one category or the other category, and why. It will also assist in establishing appropriate processes for dealing with this novel line of medical revenue recovery.
Learning Objectives –
By the end of this session, attendees will be able to:
- Identify the types of claims subject to these new laws.
- Define the action steps necessary to pursue appropriate recovery in a timely manner.
- Recognize and overcome the pitfalls and shortcomings in particular laws.
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