Ep. 52 -- Surprise (Balance) Billing with Dr. Amy Cho

Doctor Money Matters

On this episode, my guest is Amy Mecozzi Cho MD, an emergency medicine physician in MN who is passionate about making sure physicians voices are heard, particularly on the issue that is all over the news lately, Surprise (Balance) Billing. This is when the medical group providing the care charges the patient the balance between their fees and the (low) rates the insurance companies will pay. Obviously this is an unfortunate position for patients to be put in and physicians end up taking the financial and perception hits.

As an emergency physician she is required to take care of anyone who comes into the emergency department by law, physician oath and ethics, regardless of ability to pay. However insurance companies do not have to follow the same rules and can refuse to negotiate adequate reimbursement because they know physicians are bound by these laws. It’s obviously an uneven playing field. These entities have also had the ear of lawmakers and are pushing solutions to Congress that would negatively impact us. We as physicians are generally too busy to fight this, but if we don’t the results will be a disaster for those involved in patient care. I encourage you to contact your congressional representative and senators and make your voice heard on this issue. The current solution in the Senate is the Benchmark solution and would lead us to the race to bottom described by Dr. Cho on the show. The New York (Independent Arbitration) solution is the one that we need to advocate for. It’s the only real way to reach fair outcomes. The fact that insurance companies are advocating for the benchmark solution should tell you as physicians how it will be for you.

https://www.house.gov/representatives/find-your-representative

Here is an article that goes over the solutions in more detail: https://www.healthaffairs.org/do/10.1377/hblog20190708.627390/full/

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