Relating to direct payment by a health or automobile insurer of physicians and health care providers.
Impact
The enactment of SB1595 will modify portions of the Insurance Code by introducing new sections that specify the requirements around assigning benefits. Specifically, it emphasizes the direct payment provision to preferred providers, ensuring that insurers honor payment requests directly without needing an assignment of benefits. This shift could potentially reduce billing complexities faced by health care providers and ensure timely payments for services rendered to insured individuals.
Summary
SB1595 focuses on enhancing the payment process by health and automobile insurers to physicians and health care providers. The bill mandates that health insurance policy claim forms include an option for claimants to assign their benefits directly to the health care providers who delivered the services. It also establishes that payments made under this assignment cannot exceed what the insurer would have paid if no assignment was made. This change is intended to streamline payments and improve financial interactions between insurers and health services providers.
Contention
Notable points of contention in discussions surrounding SB1595 include the balance between protecting patient rights and ensuring timely payments to providers. Some stakeholders may express concerns over how this bill will affect the patient's ability to manage their own claims versus the desire for care providers to be compensated in a timely manner. Additionally, the bill's impact on ambulance service providers and how they are compensated under automobile insurance policies has raised questions about equitable treatment across various health service providers.
Relating to preferred provider benefit plan out-of-pocket expense credits for payments made by an insured directly to a physician or health care provider.