Re:California's ‘Surprise’ Billing Law Is Protecting Patient...
by riahi on Friday September 27, 2019 @11:56PM
(#21098333)
Any place that accepts insurance is bound by the terms of the insurance contract, which usually includes a most favored nation clause, meaning that you won't accept cash payment for less than the negotiated reimbursement from the carrier.
Similarly, you cannot charge less than you accept from Medicare/Medicaid.
What we can do is bill you, then write off whatever is equal to the highest contract we have. People in private practice approve this not infrequently; but corporate and mega groups have removed individual decision making and stripped us from pricing discretion. These are the pains of 3rd party payers.
I advise everyone who has an HDHP or no insurance to find a reasonable cost direct primary care. The subscription is often much cheaper than you'd think.
Similarly, you cannot charge less than you accept from Medicare/Medicaid.
What we can do is bill you, then write off whatever is equal to the highest contract we have. People in private practice approve this not infrequently; but corporate and mega groups have removed individual decision making and stripped us from pricing discretion. These are the pains of 3rd party payers.
I advise everyone who has an HDHP or no insurance to find a reasonable cost direct primary care. The subscription is often much cheaper than you'd think.