It’s a sad story that we’ve unfortunately heard more times of late than we’d care to admit: the tragic tale of the consumer who did everything right only to fall victim to everything that’s wrong about the current healthcare system. We’re talking about the practice of surprise billing, also known as balance billing, and it’s starting to affect much more than just the health of Americans.
As a refresher, surprise bills are the bills patients sometimes receive after leaving a hospital they thought was in-network with their insurance. But, alas, surprise! Here’s a bill for thousands of dollars you weren’t expecting.
The most frustrating cases of surprise billing occur with scheduled procedures where the patient does their due diligence and digs into every potential cost they might encounter to confirm their financial responsibility.
Though the patient can confirm in advance that the hospital is an in-network facility, what the patient has no visibility into is if the individual provider (like a surgeon or anesthesiologist) is an in-network provider. If they aren’t, surprise bills like the one for an “assistant surgeon” that racked up $117,000 are the result.
Angered by an outcome that seems almost incomprehensible, there are few options available to recipients of surprise bills. While negotiating with the hospital is one way to try and reduce your out-of-pocket responsibility, other patients are flat-out declining to pay the bill. However, this approach could have ramifications that go much deeper than what protesting patients are expecting.
Recent research by the Denver NBC News affiliate, KUSA, found that collections firms tasked with recouping funds from unpaid medical bills are now placing liens on patients’ homes. And while the debt sits in collections, it continues to grow due to interest.
In its initial research, KUSA found that one collections agency alone has put liens on more than 170 homes in the Denver area. Upon further exploration by NBC News, they learned that similar methods are also taking place in New Hampshire, Nevada, Ohio, Oklahoma, and Vermont.
NBC News spoke with one patient in Colorado who has endured the traumatic experience of having a lien placed on her house following an unpaid surprise bill. The $4,727 bill received by Nicole Briggs from the surgeon who completed her appendectomy procedure increased to $5,802.08 with interest. The collections agency took Briggs to court—and won—then placed a lien on her home and began garnishing her wages by 25% each month.
Hospitals argue that they have no say in which insurance plans these independent doctors at their facilities accept. On the flip side, they still actively seek out these independent physicians via out-of-network contracts that are revenue-generating relationships for the hospitals. According to NBC News, the hospital where Briggs had her surgery predominantly uses independent physicians, like many hospitals across the country.
Federal lawmakers on both sides of the aisle have recognized the need to rectify the situation by ostensibly banning surprise billing. In fact, there are three different bills currently in Congress, each with the goal of ending the practice. But until there is approved legislation, patients will remain on the hook.
If you are one of the 40% of insured adults ages 18 to 64 who received a surprise bill in the past year, we want to hear from you. By sharing your story, you might be able to help someone else avoid receiving a surprise bill.
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