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Medical Bill Mediation Program a Success

Friday, July, 13, 2018

The Texas state mediation program run by the Texas Department of Insurance has proven successful for helping patients deal with large medical bills.


It is no secret medical bills can come unexpectedly and be far more than anticipated.  Many people with chronic or serious illnesses are facing hundreds of thousands of dollars in medical bills – bills they will never be able to afford to pay and that put them at risk for bankruptcy.


But if a patient files for bankruptcy, medical billers never receive payment.  This risk means they are more likely to work with patients on payments.  The state mediation program has stepped in to oversee the process and to ensure that patients are off the hook for large bills while arrangements are made by insurers and healthcare providers.


In 2015, Texas lowered the threshold of the mediation program to include medical bills of $500 or more.  Prior to that, the program only helped patients in the Employees Retirement System and preferred provider organization plans.


The majority of bills in the program are for more than $1000 and about 11 percent in 2018 have been for more than $5000.


There have also been issued with patients determining under what circumstances emergency medical care is necessary.  More and more these days, patients are forced to seek expensive medical care and then seeking mediation to help them deal with the unexpected medical expenses.


A request for mediation is only granted if the patient’s health insurance plan is not eligible or if the medical bill is under $500.  To date, the Texas Department of Insurance has helped resolve more than $15 million worth of payments since 2015.