By: Maria Williams

In a healthcare landscape often dominated by complex billing systems, Patient Fairness has emerged as a vital resource for patients grappling with unfair medical bills. Founded by Matt Ungs, a seasoned expert with nearly three decades of experience working within health insurance networks, the company is dedicated to empowering patients to stand up against the confusion and exorbitant costs of medical billing. The company’s mission resonates particularly in Texas, where unique healthcare laws and challenges have made the state a focal point for their efforts.

Why Texas?

Texas stands as a significant battleground for patient advocacy, largely due to its distinctive healthcare laws and the frequent occurrence of surprise medical bills. Texas law prohibits balance billing for care provided at in-network facilities by out-of-network providers, along with certain diagnostic and laboratory services. In theory, these laws should protect patients from unexpected bills, yet many still find themselves receiving inflated charges. 

As Matt Ungs explained directly in a recent one-on-one interview, this is because many providers have been slow to adapt to the new regulations. “Many providers have not revised their billing practices to comply with these federal and state laws because they are reluctant to change billing practices due to the risk of reduced revenues, do not understand that their balance billing practices may now be illegal under these laws, or they simply have not given sufficient attention to complying with these laws.” 

The problem is particularly acute in Texas due to the prevalence of free-standing emergency rooms, which often result in hefty, unexpected bills for patients. Texas is also one of the states with a high number of complaints about balance billing from ground ambulance services despite state laws banning these practices for certain health plans. Ungs noted that “ambulance providers are reluctant to change billing practices due to the risk of reduced revenues… They simply have not given sufficient attention to complying with the law.”

Why Patient Fairness is Essential

The healthcare system in the U.S. has long been criticized for its opacity, with medical billing practices being one of the key areas of concern. Patients frequently face confusing and sometimes erroneous medical bills that leave them feeling helpless. This issue has only been exacerbated in recent years as healthcare costs continue to rise while patients are left to navigate a complex system without the necessary tools or knowledge to advocate for themselves. 

As Matt Ungs puts it, “I worked for health insurers for almost 30 years managing networks of hospitals and physicians. I observed over time that providers’ and health plans’ profits soared while patients faced ever-higher medical prices and insurer premiums. Providers and health plans both used patients as pawns to extract more money from the healthcare system instead of trying to reduce costs for the benefit of their customers (patients).” 

Patient Fairness steps in to fill this critical gap by providing patients with the tools and strategies needed to dispute unfair medical bills. With a straightforward three-step process—examining the bill, disputing the charges, and pursuing a resolution—the platform helps patients navigate what can often feel like an impenetrable bureaucracy. “Patient Fairness uses a 3-step process to assist persons in disputing problem medical bills,” said Ungs.

Legislative Opportunities and Challenges

While Patient Fairness works within the current legal framework to advocate for patients, Ungs also sees room for improvement in healthcare laws, particularly in Texas. One area where he believes change is necessary is in establishing clearer terms between patients and providers before care is given.

A Layer of Assurance

For those hesitant to engage with Patient Fairness, the company offers an extra layer of assurance for new customers. The process is simple: customers pay an initial fee of $49 to open a case, and the remaining balance is only charged if the case continues past 60 days. If, for any reason, the customer is dissatisfied within that period, they can request to close the case, and no further charges will be made. 

This low-risk entry point is designed to encourage more patients to take control of their medical billing situations, offering them the chance to fight back without fear of further financial strain. “We understand that some patients are reluctant to sign up with us to dispute a medical bill if they haven’t worked with us previously and are uncertain if our program and services are valuable,” said Ungs.

A Path Forward

In today’s healthcare environment, where patients are often at the mercy of opaque and sometimes predatory billing practices, platforms like Patient Fairness are essential. As the company continues to expand its presence in Texas and other regions, it offers a beacon of hope for patients who feel powerless against the tide of medical debt and surprise bills. By giving patients the tools to fight back, Patient Fairness is helping to shift the balance of power in favor of those who need it most—the patients.

Disclaimer: The content in this article is provided for general knowledge. It does not constitute legal advice, and readers should seek advice from qualified legal professionals regarding particular cases or situations.

Published by: Holy Minoza