It's a story we hear frequently from our members. You visit an emergency room or need health care which involves services like anesthesia or perhaps an x-ray. You pay what you owe for the visit and some weeks later, an invoice arrives in the mail that you simply weren't expecting. You open it up and discover another charge from the specialist group for tons of dollars. The questions naturally begin with there – What is that this? Didn't I pay for this already? Shall we be held charged again? How can this be bill excessive?
This is surprise billing, and it's an issue that impacts one out of 10 Americans each year. It is a serious problem for North Carolina.
Prior to new consumer laws that protect patients from surprise billing, even in-network providers in specialties like anesthesiology, radiology and emergency happen to be in a position to charge our members significantly greater than their peers in North Carolina and as much as 500% higher than the things they charge Medicare patients. These services are usually provided when our patients are in their most vulnerable. But there is good news on the horizon: An effort is underway to work with a large number of providers across the state to create health care more affordable for our members.
More consumer protection around the way
New federal legislation that will work January 1, 2022, seeks to prevent surprise billing. These laws establish much-needed limits on pricing, protecting consumers by ensuring services supplied by out-of-network providers tend to be more affordable. Additionally they create a process for insurers and providers to stay differences when special exceptions are needed.
Blue Cross NC is pleased Congress took steps to safeguard patients from unfair and expensive surprise hospital bills. The new laws will undoubtedly improve the problem for the members and countless Americans from getting unexpected bills at unexpected prices after they seek the care they require. We understand the chance to take patients out of the middle of this issue and negotiate directly with the most expensive for-profit providers within our network. We are able to all agree that charging as much as five times more for some patients is simply not fair and not sustainable. We're working with these providers to place a finish to exorbitant charges, together with surprise billing, permanently.
