When insurance companies use automated systems to quietly downcode a health insurance claim (reducing the billing code without ever reviewing the patient’s actual medical record), they aren’t just shortchanging providers; they’re threatening patients’ access to care by making it financially unsustainable for providers to treat those with the most complex and chronic conditions. The knock-on effect also leads to higher out-of-pocket expenses for patients.
Senate Bill 3114 puts a stop to the practice of faceless algorithms overriding a doctor’s clinical judgment and increases transparency in the process. The bill was unanimously passed by the House Insurance Committee yesterday, and awaits a vote on the House Floor.
For more information about the legislation – Click Here.