New Medical Billing Laws Take Effect in the New Year

The new year will bring a new law for medical billing companies in Houston designed to protect those in Texas state-regulated health plans against surprise medical bills for out-of-network care. Senate Bill 1264 goes into effect on January 1, 2020, after a change in the agency that drafted a set of rules for the legislation

With over 40 percent of emergency room visits throughout the country resulting in out-of-network expenses, the law was drafted with the intent of guarding patients from receiving large bills for care provided in the ER. The Texas Medical Board made up of health care providers had initially attempted to implement an exception to the law for nonemergency cases. Advocates and media coverage forced the board to give up its authority to the Texas Department of Insurance to draft the rules for the law that Houston medical billing companies would follow.

Surprise Billing Law Protects Home Health Billing

The driving force of the surprise billing legislation was to establish a way for patients to choose a doctor out of their insurance networks without incurring massive bills from physician credentialing services for care. Patients can sign a release form stating that they understand out-of-network services will be billed. The Texas Medical Board had tried to stipulate that patients would need to do so before any nonemergency procedure.

As it stands now, when insurers and providers cannot decide on a fair price for care, patients receive surprise bills, often at exorbitant prices. The new law establishes a process for insurers and providers to negotiate fair out-of-network prices for home health care billing without having to involve the patients in the arbitration.

Preventing Surprise Medical Bills

As Texas prepares for the new law aimed at preventing surprise medical bills, the federal government continues efforts to enact federal laws to continue. Bipartisan efforts calling for changes in the way emergency care is billed received pushback from physician and hospital groups concerned about damaging cuts to doctor payments.

Insurance companies claim the kind of arbitration guidelines outlined in the Texas law would lead to even higher costs and a flood of arbitration claims that would bog down the system.

The overriding principles behind surprise medical billing legislation include the following concepts:

• Patients should never be responsible for out-of-network emergency care costs that were not agreed to beforehand
• Patients should receive an upfront bill for nonemergency care with a clear pricing schedule for the services they are responsible for
• Patients should not receive surprise bills for medical care and services from out-of-network providers that were not selected by them

Surprise Medical Billing Law Starts Jan. 1, 2020

Medical debt has long been a top reason that people find themselves filing for bankruptcy, and many of those were hit with surprise medical bills for expenses through medical billing companies in Houston related to care provided out of their network. Texas State Senate Bill 1264 goes into effect on January 1, 2020. Patients who wind up in the emergency room can now be assured that their insurance will cover all care received in the ER.

Contact Dominion Revenue Solutions for Your Healthcare Billing Needs 

For complete information on the wide range of services available at the most respected medical billing companies in Dallas or Houston, Texas, contact Dominion Revenue Solutions. Dominion Revenue professionals strive to not only maximize revenue but also build relationships. Seek out their Facebook page to keep in touch with industry professionals.