Ending Surprise Medical Bills

You’ve probably read the headlines: the bill for $117,000 for a “scrub-in” assistant surgeon that a patient never met, or the $21,000 bill for the anesthesiologist who gave a woman an epidural during labor, or the $17,000 bill for the tests an inpatient received. These may be different bills, but the story is the same.

Here’s how it typically happens: You need hospital care and have insurance to cover the procedure. You check your provider directory to make sure the hospital and the doctor are in-network and even call your insurer to know what to expect for your copay and deductibles. Everything at the hospital goes as expected and you head home. Then, while you’re recovering, the bill arrives — and it is hundreds, maybe even thousands, of dollars more than you expected. A few calls later, it turns out that a specialist, or the lab used by the hospital, or the anesthesiologist was not in your insurer’s network. And now you're stuck with a “surprise medical bill.”

With the average surprise emergency room bill costing the consumer about $600 — and oftentimes even more — surprise medical bills run up costs far greater than what many Americans have in their savings accounts.

And when out-of-network providers demand outrageous fees from our insurers, we’re also likely to pay for part of that, too, in higher premiums. One study found anesthesiologists charging private insurers 3.5 times as much as Medicare.