Surprise Billing in Surgery —Time for Action

“Surprise” billing occurs when patients with health insurance receive care from a clinician or facility included in their insurer’s network (“in-network”) but unexpectedly receive “surprise” bills from other clinicians involved in their care who are not in the patient’s insurer’s n etwork (“out-of-network”) and therefore not covered by their insurance. In this issue of the JAMA, Chhabra and colleagues present a thorough analysis of out-of-network billing for elective operations and find the practice to be both common and potentially financially devastating. Based on their analysis of 347 356 patients who had undergone 1 of 7 common elective operations with in-network surgeons at in-network facilities, the authors report that 20.5% of these surgical episodes also had an associated out-of-network bill, with a mean potential financial liability of more than $2000. The most common sources of the out-of-network bills were surgical assistants and anesthesiologists.
Source: JAMA - Category: General Medicine Source Type: research