Out-of-network billing is becoming a bigger problem for patients, study says — 5 takeaways

Out-of-network billing is increasingly common for privately insured patients, even if they’re treated at in-network hospitals, according to a study published by JAMA Internal Medicine.

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Five takeaways:

1. Researchers analyzed 5,457,981 inpatient admissions and 13,579,006 emergency department admissions from 2010-16. The sample included privately insured patients.

2. The incidence of out-of-network billing rose from 32.3 percent to 42.8 percent of emergency department visits.

3. The mean potential liability to ED patients increased from $220 to $628.

4. The incidence of out-of-network billing for inpatient admissions rose from 26.3 percent to 42 percent.

5. The mean potential liability to inpatients increased from $804 to $2,040.

More articles on coding, billing and collections:
Key ways ASCs can identify bundled payment partners
3 steps to ensure successful billing at a new ASC
3 steps to negotiating an insurance contract for an ASC 

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