State insurance regulations don’t apply toself-insured group plans, as those are federally regulated.
The more you know, the better you’ll be able to navigate the system.
Using this information, hospitals may ask for upfront payment from some patients but not others.
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How Much Will You Actually Owe?
And double check their estimate with your health plan, to see if they’re roughly the same.
How Much Do You Owe Upfront?
That presents a conundrum when people have an unexpected but necessary medical procedure and a fairly high deductible.
In other situations, including a pre-scheduled surgery, healthcare facilities can ask for some payment upfront.
So patients need to understand their rights.
Wisconsin State Journal.Bill Comes Before Baby, As Hospitals Seek Advance Payments From Patients.
Buck, Isaac D. Hastings Law Journal.
Volume 73, Issue 2, Article 2.When Hospitals Sue Patients.
Centers for Medicare & Medicaid Services.Hospital Price Transparency.
Accessed February 17, 2024.
Centers for Medicare & Medicaid Services.Transparency in Coverage.
Accessed February 17, 2024.
New Choice Health.What can affect the cost of an MRI?
Claxton, Gary; Rae, Matthew; Levitt, Larry; Cox, Cynthia.
Peterson-Kaiser Health System Tracker.How have healthcare prices grown in the U.S. over time?
Centers for Medicare and Medicaid Services.Emergency Medical Treatment & Labor Act (EMTALA).
Centers for Medicare and Medicaid Services.Medicare Claims Processing Manual Chapter 2 - Admission and Registration Requirements.
Kaiser Family Foundation.2023 Employer Health Benefits Survey.
Board of Governors of the Federal Reserve System.Report on the Economic Well-Being of U.S.
Households in 2022 - May 2023.
