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Opinion

Commentary: Court protects patients in ER billing issue

The Fresno Bee

December 09, 2008 10:40 AM

This editorial appeared in The Fresno Bee.

For once, California residents won a major health care battle. Now patients who end up in a hospital emergency room cannot be billed for services that are covered by their health insurance – care they already paid for through insurance premiums, deductibles and co-pays.

The Superior Court judge in Sacramento on Wednesday upheld a state regulation, which took effect Oct. 15, clearing up the issue. That means patients no longer will be caught in the middle of billing disputes between emergency room doctors and insurers.

Here's how that has happened. Say you end up at the nearest emergency room with a life-threatening illness or injury. It's out of your health insurance network, which is no fault of yours because it's an emergency and you have little choice in the matter. The ER doctor charges $1,200, but the insurance company only wants to pay $900.

The patient often is asked unfairly to pay up. When doctors and insurers don't agree on a payment, patients have ended up getting charged the difference, which is called "balance billing."

To read the complete editorial, visit The Fresno Bee.

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