Collector – July 2019 - 44

BUSINESSOPERATIONS

Balance it Out
Researchers, health care professionals and policymakers are working to solve the puzzle of surprise medical bills.
While there are many pieces at play, collection agencies and their provider clients are part of that solution.
By Katy Zillmer

W

orking with consumers to
explain and help resolve their
overdue medical bills is a
complex process for accounts receivable
management companies and their health
care provider clients. Add into the mix
unexpected charges on a consumer's bill,
and all parties involved face challenges to
find a solution.
This issue is known as balance billing, and
it refers to any time a consumer's insurance
pays part of the bill but the consumer is
responsible for paying the balance, often for
care they didn't realize was out of network.
While the balance billing debate continues
on the federal level, some states-including
Florida, New York, New Jersey, California

44

and Connecticut-already have laws on
the books. However, consumers are not
fully protected because states don't have
the authority to regulate some insurance
products-such as employer-sponsored
plans, according to the Commonwealth
Fund's podcast, The Dose.

LEGISLATION CHALLENGES
In California, an amendment to the state's
health and safety code, which is designed
to address balance billing, took effect July
1, 2017. A.B. 72 applies to non-emergency
care that's provided at an in-network
facility but performed by a physician
that is out-of-network with the patient's
insurance plan.

"The obvious problem that this has
created is that it is difficult for the provider
to know if the patient was in-network at
the facility or if the services were part of
some non-emergency treatment that would
require A.B. 72 to be applied," said Courtney
Reynaud, president of Creditors Bureau
USA as well as president of the California
Association of Collectors Inc.
Reynaud said after the legislation took
effect, some provider clients stopped
referring accounts to collection with charges
that could potentially fall under A.B. 72.
Often they had no mechanism to determine
if the services were emergency or nonemergency, and if the services were provided
at an in-network facility.

ACAINTERNATIONAL.ORG


http://www.ACAINTERNATIONAL.ORG

Collector – July 2019

Table of Contents for the Digital Edition of Collector – July 2019

Upfront
Industry News
Best Practices
FYI
Collection Tips
What you need to know about the CFPB’s proposed new rule for the debt collection industry
“I don’t know about you, but I’ve literally never received a telegram and wouldn’t even know how to send one.”
Celebrating 80 Years of Helping Members Succeed
How Does ACA Help Members Succeed?
A History of Advocacy
8 Decades of ACA’s Annual Convention
Calendar
Honor Roll
Education Spotlight
Tell It Like It Is: Washington Hears From ACA Members
Collectors Challenge 2019: Getting Creative for a Good Cause
Balance it Out
Balance Billing Challenges Continue
It’s All About You: Helping Members Succeed
Sandbox Rules
What is a Product Sandbox?
in 11th Circuit Case Examining What Constitutes an ATDS
ACA SearchPoint
Ad Index
Membership
Last Word
Collector – July 2019 - Cover1
Collector – July 2019 - Cover2
Collector – July 2019 - 1
Collector – July 2019 - 2
Collector – July 2019 - 3
Collector – July 2019 - Upfront
Collector – July 2019 - 5
Collector – July 2019 - Industry News
Collector – July 2019 - 7
Collector – July 2019 - 8
Collector – July 2019 - 9
Collector – July 2019 - Best Practices
Collector – July 2019 - 11
Collector – July 2019 - FYI
Collector – July 2019 - 13
Collector – July 2019 - Collection Tips
Collector – July 2019 - 15
Collector – July 2019 - What you need to know about the CFPB’s proposed new rule for the debt collection industry
Collector – July 2019 - 17
Collector – July 2019 - “I don’t know about you, but I’ve literally never received a telegram and wouldn’t even know how to send one.”
Collector – July 2019 - 19
Collector – July 2019 - 20
Collector – July 2019 - 21
Collector – July 2019 - 22
Collector – July 2019 - 23
Collector – July 2019 - Celebrating 80 Years of Helping Members Succeed
Collector – July 2019 - 25
Collector – July 2019 - How Does ACA Help Members Succeed?
Collector – July 2019 - 27
Collector – July 2019 - 28
Collector – July 2019 - 29
Collector – July 2019 - A History of Advocacy
Collector – July 2019 - 31
Collector – July 2019 - 8 Decades of ACA’s Annual Convention
Collector – July 2019 - 33
Collector – July 2019 - 34
Collector – July 2019 - 35
Collector – July 2019 - Calendar
Collector – July 2019 - Honor Roll
Collector – July 2019 - Education Spotlight
Collector – July 2019 - 39
Collector – July 2019 - Tell It Like It Is: Washington Hears From ACA Members
Collector – July 2019 - 41
Collector – July 2019 - Collectors Challenge 2019: Getting Creative for a Good Cause
Collector – July 2019 - 43
Collector – July 2019 - Balance Billing Challenges Continue
Collector – July 2019 - 45
Collector – July 2019 - 46
Collector – July 2019 - 47
Collector – July 2019 - It’s All About You: Helping Members Succeed
Collector – July 2019 - 49
Collector – July 2019 - 50
Collector – July 2019 - 51
Collector – July 2019 - What is a Product Sandbox?
Collector – July 2019 - 53
Collector – July 2019 - in 11th Circuit Case Examining What Constitutes an ATDS
Collector – July 2019 - 55
Collector – July 2019 - ACA SearchPoint
Collector – July 2019 - Ad Index
Collector – July 2019 - Membership
Collector – July 2019 - 59
Collector – July 2019 - Last Word
Collector – July 2019 - Cover3
Collector – July 2019 - Cover4
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