Federal mandate requires hospitals to list prices online and why these amounts should not be relied upon.
The Detroit Free Press is reporting that hospitals across the country are now required to publish their prices online. This is part of a new federal mandate by the Centers for Medicare & Medicaid Services to improve price transparency in health care. It is an extension of a provision contained in the Affordable Care Act (Obamacare).
Experts warn consumers not to rely upon these online prices. Patients should not avoid seeking medical treatment just because of the cost. Published amounts are starting points for insurance companies to negotiate steep discounts. Even patients who are uninsured typically pay much less.
We found this article fascinating because medical bills are something our clients deal with on a regular basis. Employees hurt on-the-job should not be responsible for payment. Medical bills are covered by the employer or its insurance company without any co-pays or deductibles. This includes all reasonable and necessary medical treatment.
Michigan law requires hospitals and doctors to accept payment based upon a workers’ comp fee schedule. This is known as “cost containment.” It is not uncommon to see a $5,000 MRI be cost contained to $750. All charges must be submitted on a proper claim form such as the CMS 1500 or UB-92. Balance billing of the difference is not allowed. Medical costs under workers’ comp in Michigan are some of the lowest in the United States.
Sometimes it is difficult to get the responsible employer or insurance company to make payment under workers’ comp. Medical bills add up and a lawyer must get involved. Watch out for hospitals and doctors who insist on payment in full. A lawyer can negotiate prices and ensure all medical bills are paid. They can also stop harassment from debt collectors. We have seen some medical providers accept pennies on the dollar. This is very important when all medical is being paid out of a person’s settlement.
Michigan Workers Comp Lawyers never charges a fee to evaluate a potential case. Our law firm has represented injured and disabled workers exclusively for more than 35 years. Call (844) 201-9497 for a free consultation today.
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Photo courtesy of Creative Commons, by pbyrne.