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Life Health > Health Insurance > Your Practice

NJAHU: So, What Are the DOCTORS' Fees?

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The New Jersey Association of Health Underwriters (NJAHU) wants doctors to tell patients in advance about the cost of procedures and supplies.

Groups representing doctors have been putting pressure on health insurance agent and broker commissions by supporting efforts to interpret minimum medical loss ratio (MLR) provisions in the new Affordable Care Act, the legislative package that includes the Patient Protection and Affordable Care Act (PPACA), in a strict fashion.

The new minimum MLR provisions will require the percentage of health coverage revenue spent on medical care and quality improvement efforts to be 85% for large plans and 80% for individual and small group arrangements.

Agent groups are worried that the limits will add to the pressure on carriers to reduce commissions, even though, as agents see it, agents are the ones now doing the most to help consumers and small employers cope with the upheaval in the U.S. health finance system.

The NJAHU, Trenton, N.J., an affiliate of the National Association of Health Underwriters, Arlington, Va., now is suggesting that doctors who are working in what amount to one-way glass houses

ought to be careful about throwing stones.

The NJAHU has asked the New Jersey Legislature to give patients the same kind of price information from doctors that consumers can get from health carriers and health agents and brokers.

Today, the group says, patients have a hard time shopping around for care based on price because, in many cases, patients have no practical way to find out whether the prices their doctors are charging are fair, the group says.

David Mordo, the NJAHU legislative chairman, says in a statement that doctors ought to be paid properly and quickly.

“But these professionals also need to remember their Hippocratic Oath did not include a clause to put a person in collections for an unpaid bill for services that were not previously disclosed,” Mordo says.


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