Testimony on Surprise Bills Caused by Insurance Company Denials and Down-Coding

Rhonda Sandel is a TAFEC Board Member and the CEO of Texas Emergency Care Centers. On Tuesday (01/23/2018) She testified in front of The Texas Senate Business and Commerce Committee about balance bills, surprise bills and a how Insurance companies in Texas are making the situation worse.

She outlined to the committee a disturbing new trend in Texas where some major insurance payors are denying or down-coding level 4 and level 5 emergencies (the highest levels of acuity) at freestanding ERs and hospital emeregency rooms. This leaves patients with unexpected bills when they thought they were covered by their health plan.

In addition, Rhonda testified to the dangerous disregard by insurance companies of the Prudent Layperson laws which dictate that a patient gets to decide if they feel their condition warrants a trip to the ER…not insurance companies. Recent policies in other states have outright defied these laws and now it appears they are starting to do the same In Texas.

Remember, if you are an emergency room patient and your insurance company does not cover your care, the law is written in your favor. Contact the Texas Department of Insurance and file a complaint. http://www.tdi.texas.gov/consumer/com…

View Rhonda’s full interview here: YouTube Video

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