California’s Attempt to Protect Patients’ Rights
Recently, California’s Department of Managed Health Care (DMHC) has made new rules that will attempt to protect patients’ from getting caught in-between a billing dispute between their health provider and their health insurance. The DMHC fights for patients’ rights in California and educates Californians on their health care rights and benefits. They make sure that healthcare providers and insurance follow the law and do not take advantage of their customers.
On October 15, 2008, the DMHC banned hospitals and physicians from billing patients for emergency care that was not covered by their insurance.
Insurance companies and hospitals make “deals” with each other that allow patients covered under the company to receive cheaper care from those hospitals. Trouble would start when a patient goes to an emergency room that is outside of this pre-arranged “network.” Previously, when this occurred, the hospitals would send insurance companies bills that are more expensive than what an insurance company would receive from a hospital within its network. Obviously, the insurance company would not be happy about this, and they would refuse to pay the full bill. While the insurance company and the hospital dispute the bill, the hospital bills the patient the remainder of the bill’s balance instead. This practice is called “balance billing.”
The new rules will protect patients’ from balance billing. Cindy Ehnes, the DMHC director, says that the new rules would take the patients out of the dispute and that patients should never have had to pay for their medical bills if their health insurance is supposed to cover it. The rules would also protect patients from ruining their credit if they refuse to pay the balance bill, and would help repair damages to credit that have already occurred because of the balance bill.
The last thing anybody wants is an insurance billing nightmare after receiving much-needed medical care. If you are ever involved in a car accident or any other emergency, you do not have the luxury of choosing which emergency room to go to. If you did, it would not be an emergency! Insurance companies and hospitals need to remember that patients have rights too and that it is not all about money and profits. As car accident lawyers, we appreciate the DMHC’s efforts to protect patients’ rights.
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