3 On Your Side

A proposed Arizona law may help with surprise medical bills

Posted: Updated:
There's a new bill that would help eliminate so-called balance billing. (Source: 3TV/CBS 5) There's a new bill that would help eliminate so-called balance billing. (Source: 3TV/CBS 5)
AZ Sen. Debbie Lesko has introduced a measure that would make balance billing a thing of the past. (Source: 3TV/CBS 5) AZ Sen. Debbie Lesko has introduced a measure that would make balance billing a thing of the past. (Source: 3TV/CBS 5)
Senate Bill 1441 will provide a venue for patients to resolve balance billing issues like the one Wallinger was stuck with. (Source: 3TV/CBS 5) Senate Bill 1441 will provide a venue for patients to resolve balance billing issues like the one Wallinger was stuck with. (Source: 3TV/CBS 5)
(3 ON YOUR SIDE) -

Balance billing is common in the medical industry. So, if you've ever been to the emergency room or have seen a doctor, you might have experienced balance billing.

But hopefully, if things go right at the state Capitol, balance billing will be a thing of the past.

“It is a really prevalent problem that people go in and through no fault of their own they receive this surprise medical bill,” Arizona State Sen. Debbie Lesko, R-Peoria, said.

Carrie Wallinger was recently profiled in a 3 On Your Side report when she was left with balance billing.

“Panic! I don't have $9,000 to pay for something like that,” said Wallinger. 

Wallinger’s finger was injured breaking up a fight between her dogs. Although the hospital she went to was "in network," the doctor called in from the Arizona Center for Hand Surgery to repair her finger was out of network.

[READ MORE: Valley woman receives surprise hand surgery bill]

After getting paid the lower "in network" amount from Wallinger's insurance, the Arizona Center for Hand Surgery billed Wallinger the balance of $9,000.

We wanted to speak to the Arizona Center for Hand Surgery after they refused to get back with us, but they threw us out. 

“You don’t want to talk then?” Gary Harper asked.

“I'm not permitted to but I was asked to escort you off the property,” the employee said.

"Alright. Then tell whoever needs to know we're doing a news report," Harper said.

Sen. Lesko says balance billing is legal but certainly not right for consumers.

"They're left having to call the doctor, see if they can settle it, who tells them to call the insurance company and the insurance company says call the doctor and they go back and forth," Sen. Lesko said.

So, Lesko is attempting to smooth out the kinks when it comes to balance billing.

“I thought this is a big problem that affects a lot of people and I want to see if I can solve it and so that's what my legislation does,” Sen. Lesko said.

Senate Bill 1441 will provide a venue for patients to resolve balance billing issues like the one Wallinger was stuck with.

“They'll go to the Arizona Department of Insurance. The Arizona Department of Insurance will set up a phone call between the insurance company, the doctor and the patient,” said Lesko. 

If a simple phone call doesn't resolve the problem, there's another recourse Lesko says, that doesn’t take a toll on the patient like it has on Wallinger. 

"Then it will go to an arbitrator and the arbitrator will be a private arbitrator selected from a list that the Department of Insurance has and the doctor and insurance company will split the cost for the arbitrator," Sen. Lesko said.

The plan is already used in other states and apparently, works.

"In Texas, 94 percent of all of the cases are solved right there and then over the phone call and the patient is relieved of the stress and burden," said Lesko. 

Sen. Lesko says she hopes her legislation will mitigate the problems that come along with balance billing.

"There is a light at the end of the tunnel," Sen. Lesko said.

This bill passed out of the Senate. It's now being discussed in the House of Representatives where we're told insurance companies and doctors are pushing back against it. We'll stay on top of it and let you know what happens. 

Copyright 2017 KPHO/KTVK (KPHO Broadcasting Corporation). All rights reserved.


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Gary HarperGary Harper is the senior consumer and investigative reporter for 3 On Your Side at KTVK-TV.

Click to learn more about Gary.

Gary Harper
3 On Your Side

With more than 20 years of television experience, Gary has established himself as a leader in the industry when it comes to assisting viewers and resolving their consumer-related issues. His passion and enthusiasm have helped him earn an Emmy for Best Consumer Reporter from the National Academy of Television Arts and Sciences. He’s also garnered several Emmy nominations

He has negotiated resolutions with companies of all sizes, including some of the biggest corporations in the nation.

Gary has successfully recouped more than $1 million for viewers around the state, making 3 On Your Side one of the most popular segments on KTVK and the station's Web site.

He's best known for investigating and confronting unscrupulous contractors. In fact, many of his news reports have led to police investigations and jail time for those who were caught. Viewers, as well as the companies and people he investigates, regard him as consistently being thorough and fair.

Gary has been with KTVK-TV since 1997. Prior to his arrival in Phoenix, he worked for WZZM-TV in Grand Rapids, Michigan, where he was as an anchor and reporter.

Gary is from Chicago, but launched his television career in Lubbock, Texas, after earning a broadcast journalism degree from Texas Tech University. Following his graduation, he was quickly hired by KLBK-TV in Lubbock, where he enterprised and broke numerous exclusive reports. His aggressive reporting in Texas helped garner him Best Reporter by the Associated Press.

Gary has been married since 1994 and is the proud father of two sons. When he's not helping viewers, Gary is busy catching up on his favorite college and professional football teams as well as cheering on his beloved Texas Tech Red Raiders.

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