Consumer Advocates, Lawmakers Aim to Prevent ‘Surprise’Medical Bills

WHYY News | September 10, 2015 | Health Care
Unexpected financial complications can arise when out-of-network doctors and facilities aren’t clear up front about their status

Unexpected medical bills — also known as “surprise” bills — hit consumers when they’re particularly vulnerable, when they’re recovering from an illness or medical procedure.

The problem occurs when a patient visits an in-network doctor or facility covered by his or her medical insurance but is later billed for an out-of-network service. One common example is being billed at full rate by an anesthesiologist because he or she doesn’t take the patient’s insurance. In other words, an in-network and an out-of-network provider are working side by side — and the patient has no reason to suspect that they’re not both covered by his medical insurance.

That helps explain why consumer advocate NJ for Health Care — among others — is pressing legislators to pass a bill that would bring a new level of transparency cost containment to out-of-network medical bills.

Read the full story by WHYY/NewsWorks, a content partner of NJ Spotlight.