Planning Ahead Might Not Help: Surgery Patients Still Get Surprise Medical Bills

The numbers are staggering. More than one-fifth of patients who get elective surgery in the U.S. at hospitals that accept their insurance still get surprise medical bills. The numbers are higher among those who get anesthesia.

A news study of nearly 350 patients between 2012 and 2017 showed that even among those who did their best to only use facilities that honor their insurance, a whopping 21% still got hit with surprise bills, with the average totaling more than $2,000.

Dr. Karan Chhabra, of the University of Michigan Institute for Healthcare Policy and Innovation in Ann Arbor and Brigham and Women’s Hospital in Boston, who led the study, said:

“We had no idea how often this actually happened or how damaging it could be.”

If she had asked an average American family, they could have told her.

With private health insurance demanding patients pay more for their care – in the form of higher premiums, co-payments and deductibles – surprise medical bills are commonplace for emergency care and other situations when people are unable to confirm their benefits in advance.

But the new study is different.  It looks at people who have time to decide where and when to have surgery.  And yet they still get stick with huge bills.

Chhabra said:

“They might expect not to have any problems paying for care if they make sure their surgeon and the hospital are in-network.  Our study shows that is not the case.”

In more than one-third of cases when patients got surprise bills, a surgical assistant or anesthesiologist was the source. In these cases, the primary surgeon accepted the patient’s insurance but other clinicians did not.

While the patients are on the hook for the surprise bills, it doesn’t mean they should sit there and take it.  Health experts say patients should immediately reach out to the provider and negotiate the price.  Often they will receive a substantial discount.

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