The end of balance billing?

Looks like this practice may go away almost entirely in 2022. Huge win for consumers


This is an automatically-generated Wiki post for this new topic. Any member can edit this post and use it as a summary of the topic’s highlights.

Patients will pay only the deductibles and copayment amounts that they would under the in-network terms of their insurance plans.

Medical providers won’t be allowed to hold patients responsible for the difference between those amounts and the higher fees they might like to charge. Instead, those providers will have to work out acceptable payments with insurers. For the uninsured, for whom everything is out of network, the bill requires the secretary of the Department of Health and Human Services to create a provider-patient bill dispute resolution process.

There is an opt out where the doc and make you agree to their costs, but at least they have to give you an estimate of the cost and not in emergency situations.

I agree this is good for curbing customer abuse, but I am less optimistic about the healthcare cost implications. Saying the customer won’t pay more and the providers can just bill the extra, or much of the extra TBD on haggling, to the insurer is clearly a recipe for rising healthcare and/or insurance costs…


Good riddance. Went to in network hospital, CRNA was not in network. Was a planned procedure too.

They sent us a OON bill, but we ignored it. A facility that in network should not have non network providers


This sounds a lot like Medicaid. It is illegal for a doctor to send a bill for uncovered procedure to anyone identified as a Medicaid-covered patient. Unless the price is clearly disclosed and agreed to in advance.

My thoughts exactly. For transparency, this is a win. For not getting billed out of network stuff out of the blue without notice and maybe also possibly curbing drive-by doctoring, great.

But you have to wonder if that’s not going to simply trickle down to all the costs. You’ll just be warned in advance that it’ll be exorbitant, no surprises. Maybe a minor improvement but I doubt it’ll tackle the cause of the higher costs in the first place.


I think that for elective procedures, this enables customers to shop around. It’ll be harder to be a specialist that’s out of network because folks will choose the in-network one.

This may, of course, result in a waiting list for elective surgeries. Where have I heard that one before?

1 Like

correct and only for Non covered services. Same for medicare i believe. Hmm medicare for all anyone?