Healthcare News & Insights

Why these 3 specialists are most likely to generate surprise medical bills

Surprise medical bills are never welcome. New research shows they’re more likely to arise from visits to physicians in one of these three specialties.

Orthopedic surgeons, plastic surgeons and neurosurgeons are the specialists whose bills are most likely to generate surprises for their patients. In fact, 50% of mega-bills insurers receive from out-of-network doctors come from one of those three types of doctors.

Those are the findings of a new report by the New York Department of Financial Services. According to the report, too many patients are left holding the bag for surprisingly large bills because of how little coverage insurers offer for services provided by out-of-network doctors.

The report also looked at more than 2,000 consumer complaints regarding large bills for non-emergency, pre-approved treatments. Because medical providers don’t have to disclose whether or not they’re in-network before they provide the treatment, patients may not understand that they could be facing much larger out-of-pocket costs. For example, in one of the complaints a patient went to an in-network hospital for routine gallbladder surgery with an in-network surgeon. But the anesthesiologist was out-of-network, which left the patient on the hook for an unexpected $1,800 bill.

 

  • Don Trussell

    I experienced the same anesthesiologist out of network gouge. Even though the insurance information clerk assured me the clinic and doctor’s were in network I got socked with a $1,700.00 out of network bill from the anesthesiologist. Anesthesiologists are aware of the fact that they are not questioned about networks by prospective surgery patients up front and most won’t enter into contract discount agreements with insurance providers. As a result, they are getting a 25 to 30 per cent premium for their services which includes the services for a Nuse Anesthesist that wasn’t mentioned either.

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