I work in hospital collections.
There is nothing in the world worse than an out of state payer. We don’t know how to authorize. We have no contract. They pay whatever they want, and THEN we negotiate. The bill stays on the active A/R forever because we don’t want to send the patient a $10,000 bill 5 months later, but we inevitably do.
No hospital in Texas wants to deal with insurers in all 50 states. It would drive administrative costs through the roof.
Why is the out of state any different?
What can be done to make out of state coverage work? (I have no problem with billing the patient directly if the insurer doesn’t follow thru fast.)