A Laudable Step by Biden Administration to eliminate Surprise Medical Billing – Unexpected 36k air Ambulance Bills Soon to become History

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Surprise bills lead to affordability concerns for many families, which prevents them from seeking medical care. Under a rule issued Thursday by the Biden administration, surprise billing would soon be a thing of the past, and patients would no longer have to pay for surprise medical bills and emergency treatment, and costly health care services, such as air ambulance rides.

The latest guidelines include situations where notice and consent procedures would not apply. Air ambulance rides are among the most costly services for patients, often costing tens of thousands of dollars, which can go higher. Even if insurance plans partially cover the costs of an air ambulance ride, patients and their families have to pay for the balance of their bills.

Recently, Amy Thompson’s infant daughter had to be airlifted to Seattle Children’s Hospital to save her failing heart. The insurance covered the cost of her daughter’s care, but not the air ambulance ride. As a result, she had to pay a whopping $56,000 for the air ambulance ride to save her daughter’s life.

The new rule, which will come to full effect on Jan. 1, will make a major difference in the lives of many such distressed American families.

While protecting patients from surprise bills for air ambulance rides is a welcome step forward, it applies only to air ambulance services from out-of-network providers – ground ambulance services are excluded.

Ambulances have the highest out-of-network billing rate of any medical specialty. A study published in April 2020 states that 70% of ambulance rides have the potential to result in a surprise bill. Sure, ambulance subscriptions give subscribers some peace of mind, but once you call 911, several factors go out of your control. For instance, the ambulance that arrives may not be from the company you subscribe to.

With the introduction of the new bill, such surprise bills will be a thing of the past.

As far as its implications for the industry are concerned, it is still not clear how the industry is going to be affected by the new law as several terms are yet to be defined, such as – a geographic area, median network rate, etc. These definitions will profoundly impact how the IDR entities will digest the information they get from both providers and insurers.

But as far as the patients are concerned, they would no longer have to fight the surprise medical bills and worry about their finances when they are in the middle of a medical crisis.