By Jordan Rau
Three-quarters of the public — including a majority of Republicans — want the federal government to protect patients from being stuck with surprise medical invoices after they are unwittingly treated by doctors or medical facilities that are out of their insurance network, a poll released Wednesday found.
These unexpected bills, which can be financially crippling, may arise when a patient is taken to the emergency room by an out-of-network ambulance; when the emergency room is not in their insurer’s network; or when their hospital is in their network, but a doctor or specialist within that facility who treats them is not.
Although insurers prohibit in-network doctors from billing more than the insurer agreed to, such bills occur because doctors and medical facilities that do not have such contracts are unconstrained from charging whatever they want. Often they charge list prices multiple times the amount insurers agree to pay.
In urgent medical circumstances, patients are rarely in a position to investigate the financial arrangements of their caregivers or make sure they are brought to a treatment center that works with their insurer. Often patients are not aware they were seen by an out-of-work provider until the bill arrives.