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For Those With Health Insurance, Surprise Medical Bills Can Be A Hard Pill To Swallow

Elaine Thompson
A medical student checks on a patient in the hallway of the emergency room at Harborview Medical Center Wednesday, March 12, 2003, in Seattle.


When you go to a doctor or hospital that is part of your insurance plan, you can sometimes get hit with bills requiring you to pay the full amount.



For example, you sprain your wrist and make an appointment with your doctor, covered by your plan to check it out. Maybe a few X-rays are taken. But the radiologist taking those images is not in your network. A few weeks later, you get a bill saying you need to pay the full amount.


“Most of the time, you’re not picking who reads your X-rays. That’s whoever is contracted with the hospital,” said Washington State Representative Eileen Cody who represents the 34th Legislative District.


Cody said surprise bills come from physicians when they are in the middle of negotiating a contract with a particular medical practice or hospital.


According to Washington State Insurance Commissioner Mike Kreidler, 22,000 patients who visited emergency rooms in Washington state last year got hit with a surprise bill.


Some of the payments people have had to make are anywhere from a few hundred dollars to thousands of dollars.


This coming summer, lawmakers, doctors, insurance companies and hospitals will all meet to try to figure out a way to negotiate bills amongst themselves before sending them out to patients who are following the rules of their plans.


If a solution is worked out, then legislation will be introduced during the next session in Olympia.


Until then, Cody suggests if you get hit with an unexpected bill, try negotiating directly with the doctor and relaying your experience to the Washington State Insurance Commissioner's Office.