On the Fourth of July, Sidney Williams of Brownsville sliced his hand while opening a vase. He needed urgent medical treatment. So, he visited a nearby emergency clinic after a friend called ahead to see if the clinic would accept his insurance.
When they arrived, Williams said the clinic staff confirmed that the clinic would accept his insurance. He got stitches and other care from the clinic’s onsite doctor.
Later, he got a medical bill – for $6,500.
Not surprisingly, the charges were considerably higher than what Williams had expected -- the result of the physician and clinic not being a part of his insurance company’s network of providers.
Surprise medical bills like the one that landed in Williams’ mailbox aren’t uncommon in Texas. Patients can sometimes be charged thousands of dollars more than what their insurance company’s deductibles and co-pays allow for out-of-network costs.
While Williams paid the charges in full, many consumers are unable to afford such medical bills and can face severe financial hardships.
“Texans have few protections against surprise medical bills from neighborhood emergency clinics,” said AARP Texas Director Bob Jackson. “Even those patients who follow their insurance company rules to the letter can get slammed with a surprise medical bill.”
The Texas Legislature has taken action in recent years to help consumers challenge some surprise medical bills that exceed $500. But more can be done. Jackson said the Legislature should help Texans by keeping consumers out of payment disputes between insurance companies and medical providers.
“Getting better should be the first and only expectation put on the patients,” said Jackson.
-- Amber Binford and Callie Jones