CBS Spotlights Path Toward Surprise Medical Bill Relief in California

Spencer Watson
Public Policy Intern

Wednesday, July 20th, 2016

CBS Los Angeles shed light on the story of Nancy Gomez of Glendale, CA, who was slapped with a $18,000 bill for simply following her in-network doctor “upstairs to his surgical suite, and that made him an out-of-network provider.” So when she needed more treatment she double-checked that her surgeon and hospital were in-network, and was floored by another $9,000 bill for the out-of-network surgical assistant and anesthesiologist she didn’t even know were there. Nancy, who had excellent credit, is now dealing with collection notices.

Thousands of California consumers like Nancy need relief now from surprise medical bills or else the problem will escalate.CBS Los Angeles highlighted the light at the end of the tunnel: AB 72, which would ensure patients pay only in-network fees at in-network facilities, and shared Consumers Union’s tips to help CA patients cope with surprise charges:

  1. Remember there are protections in place already in California for emergency situations. Patients should be paying no more than in-network costs for emergency services.
  2. Don’t rush to pay a surprise bill. Instead: call your provider and your insurer, and advocate to not pay. (Sometimes it’s a billing mistake, and sometimes providers will negotiate down)
  3. Before a surgery, make sure the hospital or facility is in-network. Call them both to verify your specific policy is in their network and press the surgeon/main doctor to use only ancillary providers (such as anesthesiologists) that are in your network. Some patients have handwritten that requirement into the papers they sign prior to a procedure, e.g.: “I only want services by an in-network provider.”
  4. Ask your doctor if they are in-network at every office/facility/hospital in which you may be receiving care. Make sure they are not providing your care at an out-of-network outpatient surgery center.
  5. If you are unsuccessful in negotiating a medical bill on your own, state agencies may be able to help. You can request assistance through the California Department of Insurance. The phone number is 1-800-927-4357.

The path toward ending surprise medical bills is clear, but Californians will have to ask legislators to step on the gas to keep us moving forward. Doctor groups are lobbying hard against AB 72 to keep patients on the hook for unexpected charges.

If you live in California, tell your California lawmakers to back AB 72, and if you have ever received a surprise medical bill, please share your story today. Together we will close these unfair loopholes!

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