Once an insurance card and co-payment are presented, payment should no longer be the patient’s concern - if premiums are paid and deductibles are met.
Settlement will be the responsibility of the insurance company.
No more spending hours of "free-time" on the phone with insurance companies shuffling EOBs.
Medicaid recipients present their gold card at the hospital or clinic and never worry about the bills. Those of us who pay the premiums should have it as good.
Adjudication of Bills
Have you ever been been held responsible for a bill that was 18 months old, that was never submitted to your insurance in the first place? Or even worse, found out you were turned over to collections for that un-submitted claim?
My reform will no longer hold patients and families responsible for billing errors that are out of their control.
For providers: I am advocating mandatory adjudication of all bills by Medicaid and all third party payers within 30 days, after which, the money your practice is owed will be subjected to accrued interest as well.
If 45 days pass, the payer will be responsible for interest and a penalty payment. If earned and penalty monies are not reimbursed after 90 days, the insurance company will be faced with being administratively dissolved by the Secretary of State's office for fiscal insolvency.
No business plan in America would allow payment to be delayed as it is in the case of medical reimbursement.
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