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Law bans medical balance billing

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State Senator Debbie Lesko sponsored bill to eliminate the practice of  "balance billing".  24 April 2017 State Senator Debbie Lesko sponsored bill to eliminate the practice of "balance billing". 24 April 2017

Balance billing has been a problem for years and even though it's illegal in other states, it's very legal here in Arizona. But not for long.

“I'm thrilled!” State Senator Debbie Lesko says Arizona consumers should be just as excited.

Lesko sponsored a bill that helps eliminate something referred to as "balance billing" in the medical field.

And that legislation, just recently passed.

“This legislation is a big win for patients in Arizona. Now they have a way to settle their surprise medical bills; this is such a big problem,” said Lesko.

And, balance billing is a big problem. Just ask Carrie Wallinger. She was recently profiled in a 3 On Your Side and said she's a victim of balance billing.

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

[ORIGINAL STORY: Valley woman receives surprise hand surgery bill]

Wallinger's finger was injured breaking up a fight between her dogs. And although the hospital she went to is considered "in network" with her insurance carrier, the doctor who stitched up her finger is out of network.

That doctor is from the Arizona Center for Hand Surgery and after being paid the lower, in-network amount from Wallinger's insurance, they sent Wallinger a bill for the remaining balance, $9,000.

The Arizona Center for Hand Surgery has been profiled in the past for balance billing and even threw me off their property saying they did not want to talk about their billing practices.

“Here is your business card, and please leave the property,” an employee said.

“Okay, you don't want to talk. Then please tell whoever needs to know that I'm airing a news report on your billing practices,” Gary Harper said.

Senator Lesko says now consumers will get relief.

“If a patient gets a surprise bill, under my legislation they'll be able to call the Department of Insurance which will set up a telephone call between the doctor, the insurance company and the patient. In most of the cases it will be settled right then and there but if for some reason, it's not settled over the telephone call then it will go to a private arbitrator which will settle the amount and the patient will be out no more expense,” Lesko said.

Lesko says similar laws in other states are resolved more than 90 percent of the time with one call

“I’m absolutely thrilled because this is something I worked so hard on for months so I'm thankful to all the legislatures who voted for this,” Lesko said.

The good news is Gov. Doug Ducey just signed this bill into law Monday morning.

However, the downside is that it won't take effect January 2019 because the Department of Insurance needs time to set up all the guidelines and get ready for the big change.

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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