The study analyzed 18 billion health claims for 97 common services.
Here are five key notes:
1. The study found patients receiving care from out-of-network physicians get bills 118 percent to 1,382 percent higher than patients in the Medicare system for identical services.
2. The average out-of-network charge for spine disc surgery hit $10,459, which is 640 percent higher than Medicare’s $1,414.
3. Medicare pays $147 for a normal outpatient visit, whereas out-of-network physicians charge patients $260 for the same visit.
4. In Rhode Island, out-of-network physicians charged patients more than 500 percent above the Medicare rate.
5. Of the 97 services studied, 57 of them had out-of-network charges of 300 percent or higher than Medicare reimbursement rates.
More articles on coding, billing and collections:
4 reasons more people are using direct-care
Health insurance premiums rise 4% — 5 takeaways
4 things to know about ASIPP’s manuscript to survive the ICD-10 transition
At the Becker's 23rd Annual Spine, Orthopedic and Pain Management-Driven ASC + The Future of Spine Conference, taking place June 11-13 in Chicago, spine surgeons, orthopedic leaders and ASC executives will come together to explore minimally invasive techniques, ASC growth strategies and innovations shaping the future of outpatient spine care. Apply for complimentary registration now.
