Episode Details

In this health care podcast, I'm talking to Al Lewis from Quizzify. This episode also guest stars Rachel Miner from Thrive Benefits, David Contorno from E Powered Benefits, and Doug Aldeen, a health care attorney in Texas.

This episode started out being about surprise billing in the emergency room (ER) and a potential defense strategy that patients and employees can use to protect themselves from egregious billing practices. Surprise bills are when a patient gets "balance billed" for a sum above what their insurance carrier will pay. Usually this transpires when an out-of-network provider somehow or another gets involved in their care. Usually the patient has no idea this happens until after the bill comes—the big bill, in many cases, thus the surprise.

But here's where surprise billing and COVID-19 connect. You might not have thought of this because you might know that patients who present in the ER with COVID-19 and then test positive are protected from surprise bills, for the most part, by the CARES Act. But there's a couple of wrinkles. What if the patient does not actually have COVID-19? Then whatever treatment they wind up getting in the notoriously expensive ER is business as usual.

Here's another wrinkle: The cost of treatment for COVID-19 is not like it's capped. So even if an employee doesn't get a surprise bill, the self-insured employer or health plan might. And the CARES Act explicitly states that the employer or plan is on the hook to pay for it.

And one last wrinkle: Dealing with this pandemic among other things leaves about 0.0 chance that the national surprise billing legislation is gonna happen this year. But it's not like kids have stopped running into the side of the pull-out couch and needing stitches, or drug overdoses or heart attacks have suddenly vanished. There was a news article just the other day about a private equity–run ER in the Midwest continuing to dish out nasty surprise bills to their community of taxpayers at the exact same time that they were lobbying to get a piece of the federal bailout paid by taxpayers.

Al Lewis and his team over at Quizzify created this handy wallet card that patients or employees can use when they have the unfortunate experience of going to the ER themselves or with a loved one. It protects them from egregious surprise bills, thus its moniker, the surprise billing defense strategy. But nothing for nothing, this wallet card, this surprise billing defense strategy, also protects employers and health plans from these large bills in the age of COVID-19.

Al Lewis and I start our conversation talking about a New York Times article (also available here for those who don't subscribe to the New York Times) that came out recently featuring Al as well as myself and chronicles my visit to an emergency room wherein I deployed the surprise billing defense strategy/wallet card.

You can learn more at quizzify.com or connect with Al on LinkedIn. You can also connect with Al on Twitter at @quizzify and @whynobodybeliev. You can also connect with

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