Why More and More Patients Go Broke? NY State Verdict: Guilty! #1 = Insurers, #2 = Providers
PR Web |
NY State Governor
ERISAclaim.com is now offering webinars to examine the NY DFS specific findings and recommendations, and to provide practical solutions for all out-of-network providers to voluntarily and proactively comply with all NY State Government patient protection recommendations: full disclosures with out-of-network ACA discount protection under new federal health reform law PPACA (ACA, in short), Patient Protection and Affordable Care Act.
The full NY DFS report, titled “An Unwelcome Surprise: How New Yorkers
“Governor Andrew M. Cuomo did it again for
“Governor Cuomo may also have demystified a 2012 CNN Money report that more and more doctors are going broke today, when some insurers’ profits went up 73% and 78% of insured patients are 62% of all personal bankruptcies,” commented Dr. Zhou. (http://online.wsj.com/article/BT-CO-20120201-713202.html),
(http://money.cnn.com/2012/01/05/smallbusiness/doctors_broke/index.htm)
According to the
“Insurers are paying less of the cost of out-of-network care: The investigation found that insurers are moving to a system that greatly increases how much it costs consumers when they are treated out-of-network. To determine what they would pay for out-of-network care, most insurers used to use what is known as the usual and customary rate (UCR), which is supposed to be an average of actual bills for a procedure in that region. But now most are using the
In one case, a patient was approved for a surgery using the usual and customary rate. The insurer said it would pay
“And insures may often sue out-of-network providers if they don’t collect entire
In the final NY DFS report,
“The failure of insurers to provide benchmark data to allow consumers to compare out-of-network benefits has at least two detrimental consequences. First, it leads to surprise and anger for consumers who suddenly realize how little their insurance pays for out-of-network provider bills. Second, it contributes to inefficiency in the health insurance market. If consumers are unable to accurately compare apples to apples for out-of-network benefits, they may well, for instance, purchase coverage on the mistaken belief that 140% of
“Nonetheless, there is room for improvement. Reforms will require health plans and health care providers to make changes in current policies and practices. Some of those improvements may include enhanced disclosure, network adequacy requirements, standards for coverage of out-of-network health care services, and prohibitions on excessive charges for emergency health care services. As
The NY reform is the
To find out more about PPACA Claims and Appeals Compliance Services from ERISAclaim.com:
http://www.erisaclaim.com/products.htm
Located in a
For any questions, please contact Dr.
Read the full story at http://www.prweb.com/releases/2012/3/prweb9299287.htm
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