The State of Georgia Takes Surprise Billing Head-on with Agreement


The State of Georgia Takes Surprise Billing Head-on with Agreement

Feb, 21st 2017

Nobody likes receiving unexpected medical bills, especially when they followed all the rules and thought they paid what they owed. But one in five people who go to emergency rooms find themselves in precisely that situation.

It's called surprise billing: when patients go to hospitals that accept their insurance, but then end up receiving a bill for out-of-network services.

The Senate Health and Human Services Committee, which has tackled the problem for more than a year, finally reached a potential solution Thursday, unanimously passing a bill that would require the insurer and health care provider to resolve disputes over surprise bills, without involving the patient.

If the two parties couldn't come to a resolution, then the case would be decided by the Department of Insurance acting as a third party. The final amount of reimbursement would be determined using a cost database run by a nonprofit organization.

The bill also would require hospitals and healthcare providers to make it easier for consumers to educate themselves about how to avoid surprise bills.

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