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In-service patients often receive out-of-network bills

On Behalf of | Apr 1, 2019 | Medical Debt

The results of a study released recently by the Health Care Cost Institute suggests that about one in seven hospital patients receives a bill for out-of-network treatment despite obtaining their care at an in-service medical facility. The nonprofit health research group arrived at this figure after assessing almost 620,000 hospital admissions in 37 states. North Carolina was one of 15 states where between 10 and 15 percent of in-service patients were sent bills for out-of-network treatment.

In many cases, these bills surprised patients who took steps to ensure that all of their treatment options were covered by their health insurance policies. This happens because hospitals often use independent laboratories for medical testing and out-of-network doctors. Experts say the problem is getting worse because insurance providers are offering policies with more restrictions and are becoming stricter about reimbursement. In addition to determining how many hospital patients receive out-of-network bills, the IIHS study also examined the most common causes of uncovered treatment.

Anesthesiology emerged as the most common reason for unexpected bills, accounting for more than 16 percent of all out-of-network specialty services. The other common causes of out-of-network bills included independent lab work, emergency medicine, primary care, radiology and non-physicians. The researchers also noticed wide variations in out-of-network billing among states. Only 1.7 percent of the Minnesota patient records studied included a bill for out-of-network services. In Florida, the figure was 26.3 percent.

Many people find themselves in financial difficulties after an injury or illness. Unfortunately, unexpected medical bills could make challenging situations even more unmanageable. Attorneys with debt relief experience could help individuals find a way to get out from under overwhelming debt.


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