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What is The Balance Billing Act?

The Balance Billing Act is a new Texas Law that took affect in January that aims to protect people from receiving surprise medical bills. Advocates have praised the law as one of the best set of billing protections in the nation, but it only applies to one third of Texans with private health insurance.

The goal is to limit billing disputes between patients and state regulated health insurance plans, and providers.

Moving forward insurers, and health care providers must leave the patient out of billing disputes and negotiate prices for out of network care using an arbitration process.

The new law also bans balance billing for emergency care. In nonemergency situations, there is an exception that allows providers to charge balance bills to patients who intentionally seek out-of-network providers. In those cases, the state’s insurance agency offers a disclosure form for providers to ask patients to sign.

The law applies to Texans with state-regulated health plans, which includes most state employees and public school teachers, people who purchase insurance through the Affordable Care Act marketplace and some people who receive health insurance through their private employers. A person’s health insurance card will bear a “TDI” or “DOI” imprint if the health plan is state-regulated.

To find out more contact one of MedRights advocates today.

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