Often, when you are in the most vulnerable state, such as in an emergency or when your doctor/family uses an out-of-network provider [according to a national study at Johns Hopkins University], these little lives The surprise will appear. For example, you may be treated in a network emergency room, but this does not mean treating your doctor on your network. The opposite can also happen: your doctor is on the network, but you are being treated at a facility outside the network. How do you know that?
400,000 doctors
The study shows that since you have not chosen a doctor, if they take your insurance, you will not know in advance. This shocked those who received bills for months or even thousands of dollars after receiving treatment, from receipts from unsuspecting suppliers!
A total of 400,000 doctors were searched across the United States, ranking the difference between the cost of medical insurance reimbursement doctors and the cost of patients covered by other insurance, with no or no online treatment.
The medical insurance plan is used as a baseline because the insurance company uses these fees as a starting point when calculating patient reimbursement outside the network. A typical doctor's fee is about 2.5 times the amount paid by Medicare. However, the highest markup comes from a doctor who has not been selected by the patient.
Doctor charge
Typical anesthesiologists, emergency physicians, pathologists, neurosurgeons, ambulances, and radiologists charge at least four times the Medicare reimbursement [the anesthesiologist averages six times].
The doctors who usually see the most use the lowest fare increase. These include general practitioners, immunologists, dermatologists, psychiatrists, family doctors and allergie specialists. They charge less than twice the Medicare rate. Also noticed regional differences. For example, doctors in Alaska and Wisconsin raised the cost of patients to about twice the cost of doctors in Hawaii and Michigan.
It is getting worse and worse
As healthcare systems become more complex, insurers may reduce the reimbursement rate of contract doctors [and facilities], which may cause doctors [and facilities] to opt out of the insurance network when the contract expires. As a result, the doctors [and facilities] on your network are now out of the network.
As of the spring of 2016, 23 states have been working hard or have implemented consumer protection measures. For additional information, please check the insurance department website for your state.
The steps you can take
The best hedge for unexpected medical bill balances is to prevent and advocate yourself by taking action before the billing agency closes the bill.
- Conduct research, planning and preparation before an emergency occurs.
- For non-emergency care, confirmation treatment will be provided by the network provider.
- When providing your insurance information, be sure to refer to your plan with its full name. Most large insurance companies have sub-plans that may or may not include network providers.
- Maintain communication document logs.
- Ask for the name of the provider [or facility] that will be involved in your care. Please consult your insurance and the supplier yourself to determine if they are on the network, not your insurance.
- Check your state's insurance regulatory information to determine consumer protection measures for accidental medical bill balances.
- Your insurance may state that you do not have a balance; however, if there is no contract between your insurance and the provider, you may still owe the balance [if no state law applies].
- If you find an outstanding balance, you can negotiate with the provider to reduce the balance. Find out the average cost of surgery in your area.
- If your insurance is through your employer, please contact your Human Resources department.
- Confirm that the provider is not on your insurance network.
Orignal From: Why are medical bills the main cause of bankruptcy?
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