Texas doctors say they are on board with an effort by U.S. Rep Lloyd Doggett (D-Austin) as well as state lawmakers, to try to rein in so called 'surprise' medical bills, News Radio 1200 WOAI reports.
Dr. Ray Callas of the Texas Medical Association tells News radio 1200 WOAI that doctors are also worried about the rising costs of medical care, and the uncertainty patients feel when they visit the doctor.
"We do not want to economically cripple any patient while providing medical care,' Dr. Callas told News Radio 1200 WOAI.
A bill introduced on Thursday by Doggett, which mirrors bills already proposed in the Texas Legislature, would require that patients be told if one of the physicians who is treating them is 'out of network' with their insurance company, and the patient would be allowed to opt out of receiving care from that physician.
If the patient is incapacitated and is unable to provide that consent, the 'out of network' doctor would have to bill the patient as 'in network' rates.
Dr. Callas says another problem is with insurance companies declining to extend 'in network' status to physicians.
"If we allow more physicians to be 'in network' that would help the instances of 'surprise billing' to fall precipitously," he said.
Dr. Callas, who heads the TMA's Council on Legislation, says another proposal being floated in the Texas Legislature which the doctors support would be to allow mediation for 'surprise bills.
'A 'surprise bill' is a medical bill that a patient frequently receives from a doctor or technician the patient didn't even know was involved in his or her care. Patients frequently go to a hospital or doctor who is 'in network' with their insurance plan, but don't realize that lab technicians, or support physicians like radiologists are not in network. Six weeks later, the patient gets a huge bill in the mail from that doctor.
Dr. Callas says insurance companies should make it easier for patients to learn before choosing a hospital or other provider if those 'back office' physicians are covered. He says that should be as easy as checking your bank balance on line.
"We want to make it a more fair, 'live' directory or patients know what they are getting themselves in to," he said.
Other proposals include making the prices charges for medical procedures known up front to patients. Critics say health care is the only service provider that expects patients to pay costs which are 'unknown' to them when they request the service.The system of hospital billing is also under fire. Prices charged to patients can vary wildly depending on whether they have insurance, what kinds of insurance they have, and other factors which are completely beyond the patient's control.
There is also a move to end the common practice of the hospital and all doctors involved in a patient care sending separate bills, which has been likened to buying a ticket to a Spurs game, only to get a bill in the mail from Tony Parker with an admonition that your ticket price 'didn't cover the cost of seeing me play.'
Dr. Callas says these reforms are particularly important now that 'neighborhood ER's and 'doc in the box' clinics are springing up, and other alternatives to traditional medicine, like a plan by Walmart to offer MRI services, are disrupting traditional medicine.
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