Few ‘surprise’ patient bills are from radiologists, study finds

Out-of-network billing by radiologists – often referred to as “surprise billing” – dropped significantly beginning in 2007 and imaging claims are now almost completely in network, according to a recent study. In an analysis of billing trends, the rate of out-of-network (OON) imaging claims declined from 12.6% in 2007 to 1.1% in 2021, with the decline occurring broadly across imaging modalities, noted lead author Jay Parikh, MD, of the University of Texas MD Anderson Cancer Center in Houston. “This consistent decline over time likely reflects in part effective persistent good-faith negotiations between radiology practices and commercial payers in the context of dynamic ongoing contractual landscape,” Parikh and colleagues wrote. The study was published January 19 in the Journal of the American College of Radiology. Out-of-network balance billing occurs when an individual with private health insurance is administered unanticipated care from a clinician who is not in their health plan’s network. Given the potential financial burden to patients, Congress passed the No Surprises Act in 2020, which holds patients responsible only for the in-network cost-sharing amounts of their insurance plans, the authors explained. They added that policymakers have implicated radiology as a specialty that is potentially problematic for surprise billing, yet the rate of out-of-network billing by radiologists over time has not been previously studied, they wrote. Thus, to clarify...
Source: AuntMinnie.com Headlines - Category: Radiology Authors: Tags: Practice Management Source Type: news