Every day, accounts receivable services will run into problems on how to bill a patient for a previous procedure. Insurers issue their percentage rate of coverage, while the cost of using some practitioners may be more expensive than intended.
Before you know it, the patient is talking to medical billing department, even if these professionals may not have all the answers. This problem happens extremely often in the United States, but that may no longer be the case if New York if Governor Andrew Cuomo has his way.
Cuomo announced last week that he plans on passing a law that will prevent patients from going under the knife, just to wake up with a larger amount of debt due to last-minute changes like the use of a radiologist or anesthesiologist not covered by their health insurance plan, the Associated Press reported.
"Patients are complete collateral damage in the wars between carriers and providers," Elisabeth Benjamin of the Community Service Society, an organization that receives these complaints on their help line, told the source. "It just happens all the time. The patient has the least amount of bargaining power."
Unlike other bills, which take some time before going into effect, Cuomo announced that once this specific proposal is approved, it will be active immediately. If there are situations where a patient feels their bill was higher than expected, they would be allowed to take their claim to an independent arbitrator.
Physicians, finance departments and insurance agents who operate within the Empire State would have to be in constant communication with one another to ensure these incidents occur on a less frequent basis. This proposed law is also intended to cut down on "balance billing," where doctors will ask patients to cover the leftover balance once health insurance was applied, in addition to the doctor's fee.
"It's the [number one] complaint we get at the Department of Financial Services," Superintendent Ben Lawsky added.
Medical accounts receivable in New York State may experience further delays in their operations if this plan becomes law. Because more time will be spent communicating with multiple parties to ensure every patient receives an appropriate bill, it will take some time to adjust to this new procedure. Outsourcing to a medical billing provider can reduce the amount of backlog and outstanding balances to hospitals and doctor's offices.