Commentary: Who Pays the Doctor?

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(Sacramento, CA)
Friday, August 22, 2008

Beginning Oct. 15, patients no longer will be caught in the middle of pay disputes between emergency room doctors and insurance companies. It’s about time.

When you have a medical emergency, you don’t always have a choice about the doctor you see.  Sometimes you get care from doctors outside your health plan network. And there’s the rub.

The insurance company is supposed to pay the emergency room doctor. But some doctors who believe these payments are too low, often turn around and send bills to patients for the difference. This is called "balance billing." Many times, patients don't realize that these bills aren’t their responsibility. So they pay them. And if they don't pay, they get collection agencies hounding them. That’s just wrong.

That’s why Governor Arnold Schwarzenegger pushed for the new state regulation that outlaws balance billing for emergency care. And, patients don’t have to wait until October to get relief. If you receive an emergency room bill you feel you don’t owe, even before October, you can contact the state’s HMO Help Center. The number is 888-HMO-2219.

Now, everybody in the health care system can focus on going after insurers to pay bills they are legally obligated to pay – and leave patients out of it. That’s the way it should be.


Pia Lopez writes for The Sacramento Bee opinion pages.