Surprise Billing Protection in WA – Coming 2020
The Washington state legislature passes a bill to prevent balanced billing taking effect January 1, 2020.
Second Substitute House Bill 1065 (www.leg.wa.gov) prevents consumers from getting a surprise bill when they seek either emergency treatment at an out-of-network emergency room or medical services at an in-network hospital or facility but are treated by an out-of-network provider.
Up until January 1, 2020 if you have a medical service done at an in-network provider/hospital and an out-of-network provider walks in your room to provide any service (i.e. anesthesiology, pathology, radiology, lab services) it is very likely that you will pay more for those services even though you are having it done at an in-network hospital.
Balance Billing – When a provider bills you for the difference between the provider’s charge and the allowed amount.
In-network provider – a medical practitioner, clinic, hospital…who have contracted with your health plan. The health plan and provider have predetermined the allowed amounts for all services. Typically called “preferred providers”.
Out-of-network provider – a provider that does not have a contract with your health plan. This is where you may be balanced billed.
Preferred Provider – A provider who has a contract with your health insurer or plan to provide services to you at a discount. Check your policy to see if you can see all preferred providers.