Herrman & Herrman September 2018

One Answer to Surprise Medical Bills

Medical providers, such as hospitals, doctors, and other health care specialists, have a practice called “balance billing,” which often causes people to receive surprise medical bills. Balance billing is when a medical provider bills the patient for the difference between the provider’s charge and the amount allowed by the patient’s own health insurance. This is typical for out-of-network physicians who are not bound by a contractual “in-network” agreement, which gives them the ability to bill the patients for the entire remaining balance. One kind of balance billing occurs when a health care provider charges more for a provided service than what the health insurance company allows. For example,

The Texas Department of Insurance (TDI) has a consumer protection program that helps people with surprise medical bills. A Texas law has allowed many consumers to seek mediation when their balance exceeds $500. The TDI’s website states, “If you were surprised to get a bill from a doctor, hospital, or other health care provider that isn’t part of your health plan’s network, we might be able to help.” You can read more at tdi.texas.gov/consumer/cpmmediation.html .

According to the TDI, balance billing complaints are up 1,000 percent in Texas. The number of balance billing complaints rose from 112 in 2012 to 1,334 in 2015. In addition to seeking the TDI’s help, consumers can also try to negotiate with the medical provider directly. Many providers offer payment plans and will agree to provide discounts if you pay in cash immediately.

a provider may set their own charge for a service at $150, while your health insurance only allows up to $100 for that specific service. The provider may then turn around and bill you the remaining $50 that your health

insurance did not cover. Another kind of balance billing occurs when a patient receives medical care by a provider who is believed to be “in-network,” but it later turns out that the medical provider was not “in-network.”

Inside-Out Grilled Ham and Cheese

Want to take your grilled cheese game to the next level? This recipe calls for cheese both inside and outside the sandwich, adding a crispy crunch to the grilled cheese experience. It’s a quick, delicious weekday dinner option the whole family will love.


1. Butter each slice of bread on the outsides and sprinkle with Parmesan. 2. Layer ham and cheese evenly on top of 4 slices of bread. 8 slices of bread (Pullman works best) 4 tablespoons unsalted butter, room temperature 1/2 cup freshly grated Parmesan cheese (preferably Parmigiano-Reggiano) * * INSTRUCTIONS *

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8 ounces ham, thinly sliced 1/2 pound Swiss cheese, sliced 2 tablespoons Dijon mustard 1/4 cup apricot preserves

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3. Spread apricot preserves and mustard across the other 4 slices. Press sandwiches together. 4. In a cast-iron skillet or large sauté pan over medium heat, grill sandwiches until golden, about 3 minutes per side. 5. Cut in half and serve.

Inspired by Bon Appétit magazine




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