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Mediation Results in Reduced Charges by Doctors in Texas

Monday, February, 12, 2018

Texas’s medical mediation program has resulted in millions of dollars in relief for patients.  There were more than $7 million in surprise medical costs taken to mediation, and estimates show doctors reduced their costs by approximately $6 million.


Throughout the state, patients, doctors, and insurers are in crisis over confusing billing practices.  Balance billing, as it was called, costs patients millions of dollars annually.  This system allows doctors outside of patient’s network to charge more than they should and then shift that costs to patients when the insurance company refuses to pay for the inflated cost. 


The governor signed a law in 2017 that revised Texas’s mediation process that often provided relief.  If a bill in question is more than $500 the patient can request their insurer arrange a phone conference between the company and the doctor to attempt to compromise.  If no compromise can be reached, the dispute will move to a hearing.  The laws expands the scope of mediation to allow the process to include bills from free-standing emergency rooms.


Those familiar with the program say that doctors and healthcare providers received as much as $1 million in the mediation sessions, but ended up forgiving about $6 million in costs.  And had the mediation sessions not been held, patients would have ended up paying about $7 million more than they did throughout the year.  Supporters of the program advise all patients to attempt mediation if they believe their costs to be too high and point out that many problem paid far more than they should have.