Balance Billing

This one is a bit of a bother; my conscience versus insurance company shenanigans...

The LA Times reports that consumer groups are getting their noses out of joint about the practice of balance billing, where a health care provider tells the patient that the insurance company did not cover the fee and charges the patient directly. If you're a patient, that's a pretty scary prospect. The San Diego Union-Tribune reports on the state's attempt to outlaw the practice.

We all must know by now that primary care is under-reimbursed, so I see an opportunity to charge what we are really worth as primary care providers by balance billing. But let's face it; primary care docs are mensches. We won't do it, but the emergency rooms and hospitals will. In the absence of any price transparency, hospitals can get away with extra billing whatever they want and pretty much make up what they please.

Too many hospitals' bills read much like a work of fiction. This household has never yet received a properly itemized ICD, CPT and HCPCS coded bill. Although mistakes appear to be few and far between, it is hard to tell without the detail. I guess I can trust the insurance companies not to overpay! But can I trusty the large health care delivery entities any more???