Surprise out of network bills

Out-of-network healthcare can be costly and is often something patients try to avoid. But when an emergency occurs, a visit to an in-network hospital can still result in an unpleasant surprise — a highly expensive medical bill because the patient was treated by an out-of-network physician.

Surprise billing and related costs are increasing among inpatient admissions and emergency department visits to in-network hospitals. From 2010 through 2016, 39% of more than 13 million trips to the emergency department at an in-network hospital by privately insured patients resulted in an out-of-network bill, a new study published by medical journal JAMA Internal Medicine finds.

“This is becoming a bigger and bigger issue,” says Kim Buckey, president of client services at DirectPath. “We’ll probably see more employers working at state and federal level to put some pressure on their representatives to do something about this. They’re paying their share of these higher out-of-network costs and it’s hitting their bottom lines as well as their employees.”