DENVER — If you visit a hospital under the umbrella of your insurance network and are seen by a doctor or provider who is out of network with your insurance, a large medical bill could be headed your way.
We’ve talked about “balanced billing” before. Essentially, when your insurance company refuses to pay what that provider thinks he or she is worth, you are left with a surprise medical bill for the remaining unpaid balance.
So why are we talking about balanced billing again? Because as we inch closer toward the finish line of 2020 and hospitals try to manage the number of COVID-19 cases, patients in Colorado and beyond need to be aware of the bills they could face, even if they research local hospitals and their insurance plans.
As of Dec. 4, 1,740 people in Colorado are currently hospitalized because of the coronavirus. That number has risen by 200 since early last week when Colorado Gov. Jared Polis issued an executive order that grants the Colorado Department of Public Health and Environment (CDPHE) extraordinary ability over patient care within the state’s already-taxed hospital system.
Executive Order 260 authorizes CDPHE to order hospitals and freestanding emergency rooms to transfer or cease the admission of patients should those facilities reach “capacity to examine and treat patients.”
The order, which was slated to last 30 days, provides CDPHE flexibility to do what Colorado hospitals have already shown a willingness to do in light of growing patient-loads due to COVID-19: transfer patients from one overburdened facility to one that is more able to handle those patients’ care.
Hospitals and providers that are out-of-network with a patient's plan are "strongly encouraged to talk all necessary steps to protect consumers enrolled in their plans from being balance billed" because of the order.
That does not forbid medical providers from using this method anyway.
A Colorado state law, passed in part because of the 9Wants to Know team's "Lien of Me" series, partially covers the gap but does not help most people who get their insurance through an employer.
If you receive a bill like this because of treatment related to COVID-19, or because you are moved to a hospital outside of your network, contact us by emailing ShowUsYourBills@9NEWS.com.
Also, take some time to read more from our investigative series, so you are prepared for what a balanced bill means:
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