Out-of-Network Billing
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Health Affairs Blog: Out-of-Network Spending: Why Growing Attention Is Focused On A Small Share Of Medical Spending
Tags: Out-of-Network
Read more: Health Affairs Blog: Out-of-Network Spending: Why Growing Attention Is Focused On A Small Share Of Medical SpendingIn HCCI’s publication in Health Affairs Blog, we examine the cost and utilization of out-of-network care in commercial claims. From the article: “People receiving surprise bills, sometimes totaling tens of thousands of dollars, have been frequently chronicled by high-profile media stories and in academic research over the past several years. Previous research from the Health Care Cost…
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Health Affairs: Out-Of-Network Spending Mostly Declined In Privately Insured Populations With A Few Notable Exceptions From 2008 To 2016
Tags: Out-of-NetworkRead more: Health Affairs: Out-Of-Network Spending Mostly Declined In Privately Insured Populations With A Few Notable Exceptions From 2008 To 2016In HCCI’s publication in Health Affairs, we examined out-of-network spending in the privately insured population. Abstract: “While out-of-network or potential “surprise” billing has garnered increasing attention, particularly in emergency department and inpatient settings, few national studies have examined out-of-network care overall or in other settings. We examined out-of-network spending and use among two large nationwide…
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How often do providers bill out of network?
Read more: How often do providers bill out of network?In recent analysis, we document extensive variation across states and metropolitan areas in the frequency of out-of-network visits among individuals with health insurance provided by an employer. These differences raise the question of whether individual providers bill out of network at dissimilar rates. To explore whether a small group of providers are responsible for most…
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How common is out-of-network billing?
Tags: Commercially Insured, Emergency Room, Geographic Variation, Mental Health and Substance Use, Out-of-Network, Surprise BillingRead more: How common is out-of-network billing?Congress is considering legislation to address “surprise bills”, which occur when a person visits an in-network facility, but receives services from a provider that is outside of their insurer’s network. Bills in both the House and Senate include provisions to determine a benchmark rate for out-of-network payments based on what in-network providers of the same…
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Comparing Average Rates for Select Anesthesiology, Emergency Medicine, and Radiology Services by Local Areas
Tags: Commercially Insured, Emergency Room, Geographic Variation, Medicare, Out-of-Network, Physician Spending
Read more: Comparing Average Rates for Select Anesthesiology, Emergency Medicine, and Radiology Services by Local AreasWhen a person unknowingly receives health care services from a provider that is outside of their insurer’s network, it gives rise to the potential for a “surprise bill”. Congress continues to consider legislation aimed at reducing the financial burden of “surprise bills” for patients. The approach approved by committees in both the House and Senate…
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Comparing Commercial and Medicare Rates for Select Anesthesia, Emergency Room, and Radiology Services by State
Tags: Commercially Insured, Emergency Room, Medicare, Physician Spending, Prices, Spending, Surprise BillingRead more: Comparing Commercial and Medicare Rates for Select Anesthesia, Emergency Room, and Radiology Services by StateCommittees in both the House and Senate have advanced legislation that includes measures to address “surprise bills.” A surprise bill results when a person unknowingly receives medical care from a provider that is not part of their insurer’s network. Both pieces of legislation set a benchmark for out-of-network payments. Those benchmarks are determined based on…
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Surprise out-of-network medical bills during in-network hospital admissions varied by state and medical specialty, 2016
Read more: Surprise out-of-network medical bills during in-network hospital admissions varied by state and medical specialty, 2016Out-of-network billing practices have increasingly garnered attention as individuals with commercial health insurance continue to experience “surprise billing.” A surprise medical bill commonly describes a charge to a patient for care delivered by an out-of-network (OON) professional who works within an in-network facility. We used the Health Care Cost Institute’s (HCCI) vast commercial claims database to…