4 ms·

I feel like Anthem's proposed reason is a major complaint with health insurance (re surprise billing). It's hard because we won't believe anything they say, ev

I feel like Anthem's proposed reason is a major complaint with health insurance (re surprise billing). It's hard because we won't believe anything they say, even if our interests do rarely align. I don't agree with the take about "good faith negotiations". The non-surprise bill legislation is literally about making sure patients don't get surprise bills. It's not about helping hospitals or providers get more negotiating power. Anthem is merely regressing to the prior status quo by making hospitals share in a cost they now have. This was entirely forseeable. Providers weren't magically your friend because they give you a healthcare. Your insurance company is negotiating to keep costs down, which should help you too. Out of network anesthesiologists were never on your side.

ahmedhawas123 11mo ago
100% this. Non participating providers a big reason patients have gotten massive bills when going to an ER or an inpatient setting, esp. in rural settings, where a non-pariticipating provider is part of your care and you end up with 5/6 digit bills for that one provider. This actually protects the patient and creates an incentive for health systems to care about it.
- knollimar 11mo ago
  Well the article talks about a surprise billing law which already protected the patients, but why should insurance companies (and thus you through premiums) have to pick up the cost? I want to be able to put pressure on hospitals to accept a whole set of insurance and I'm glad insurance companies are doing so. There SHOULD be a guy saying "we should make sure his providers are all in network" at the hospital and not just make the insurance company write blank checks to anesthesiologists.
  - ahmedhawas123 11mo ago
    Totally agree - this is what I'm saying also. Reality is hospitals still have an incentive (which we see them exercise a lot esp. in rural areas) to stay out of network where they can so that they can bill claim amounts freely.

ahmedhawas123 11mo ago

100% this. Non participating providers a big reason patients have gotten massive bills when going to an ER or an inpatient setting, esp. in rural settings, where a non-pariticipating provider is part of your care and you end up with 5/6 digit bills for that one provider. This actually protects the patient and creates an incentive for health systems to care about it.

knollimar 11mo ago
Well the article talks about a surprise billing law which already protected the patients, but why should insurance companies (and thus you through premiums) have to pick up the cost? I want to be able to put pressure on hospitals to accept a whole set of insurance and I'm glad insurance companies are doing so. There SHOULD be a guy saying "we should make sure his providers are all in network" at the hospital and not just make the insurance company write blank checks to anesthesiologists.
- ahmedhawas123 11mo ago
  Totally agree - this is what I'm saying also. Reality is hospitals still have an incentive (which we see them exercise a lot esp. in rural areas) to stay out of network where they can so that they can bill claim amounts freely.