Most of us know which local hospitals and doctors are covered by our insurance providers, but even when we make sure that we only see an in-network physician or surgeon, nearly one-third of privately insured Americans are still hit with higher-than-expected medical bills, often because their in-network hospital brought in or contracted out to an out-of-network service provider. How did we get to the point where so many consumers have so little information about what to expect when their hospital bill arrives?
According to consumer advocates and a medical billing specialist who spoke to Consumerist, the problem of surprise medical bills isnt exactly new, but healthcare providers appear to be taking greater advantage of long-existing loopholes in the insurance system, leaving more patients feeling blindsided when they finally get their bills.
Its a tremendous problem that seems to be getting worse and worse, Chi Chi Wu, an attorney with the National Consumer Law Center, tells Consumerist. The big picture is that its due to peculiarities and problems and how healthcare is priced in the U.S.
At the core of the issue is the distinction between in-network and out-of-network health insurance coverage and how each is priced and passed on to consumers. In-network providers are those who have agreed to charge lower fees to customers of a particular insurer, with the expectation that being listed as a covered provider will bring in more patients.
Comment:*
Nickname*
E-mail*
Website
Save my name, email, and website in this browser for the next time I comment.
