Crushed Betwixt 2 Elephants

Here's a fascinating story almost a developing trend. It's past times Hashemite Kingdom of Jordan Shapiro at the St. Louis Post-Dispatch as well as is presented over at Kaiser Health News. (KHN, past times the way, is ane of only a few go-to media outlets when y'all desire to know what's actually happening inwards wellness care.)

Hashemite Kingdom of Jordan explains:

UnitedHealthcare, which covers only about one-fourth of Missourians, has changed the way it handles something known every bit “balance billing” — the divergence betwixt the provider’s accuse as well as the amount allowed past times the insurer. The insurer’s motility this year, designed to forcefulness downwards costs, way the insurer won’t pay the bills of some emergency room physicians as well as other specialists fifty-fifty though they run for hospitals inwards the UnitedHealthcare network. That could travel out a client amongst wellness insurance coverage stuck amongst thousands of dollars inwards unexpected expenses.

UnitedHealthcare previously would pay almost all of the nib from the emergency room doctors who performed services at an in-network hospital. But instantly UnitedHealthcare says it would scale dorsum how much it would pay. It volition instantly solely pay the prevailing out-of-network rate, leaving the residual of the nib to patients.

UnitedHealthcare blames the hospitals that contract out their emergency tending to other providers who may or may non last inwards the insurer’s network.

It feels similar the battle of the titans, amongst consumers getting crushed inwards the middle. As KHN's Jay Hancock noted on Twitter:

"What happens when Big Insurance plays the heavy amongst Big Hospitals? Consumers larn screwed."

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