意外医疗账单

惊喜，惊喜，惊喜…….你刚收到一份意外的医疗账单!

When I first heard the phrase “surprise medical bills” I had no ideas what this was. 的 term is actually pretty straight forward; a bill you were not expecting. 它也被称为“余额结算”。. 的 topic has become more publicized recently as Congress, 联邦政府, and healthcare advocates are beginning to address ever increasing health care costs, 包括意外医疗费. 的 影响 令人惊讶的医疗账单, which occurs when a patient receives care from a doctor or hospital considered “out of network” from their insurer’s network and subsequently receives a bill much higher than that of an “in network” provider. 这通常发生在医院的急诊室.

虽然这个问题正在受到关注, 出人意料的医疗账单似乎在增加, 根据 美国医学会内科杂志. 立法者和至少一个州的关注焦点, 加州, has not resulted in any consistent plan that is without criticism. 加州实施了 法律 (AB 42) that protects patients when they receive care at an in network hospital, 但是来自网络外的供应商. 的 jury is out with regard to the effectiveness of this 法律. 一些 研究 has shown it has helped protect patients from surprise bills, 然而, other 研究 has shown it 影响s provider’s ability to negotiate rates.

一些 recent 报告 have suggested that investors are influencing (and not in a positive way) surprise billing.  凯撒 报告 that many private physician groups are in fact owned by physicians, but also by savvy investors in private equity and venture capital firms. 的 business model appears to be in essence surprise billing, which results in much higher profits. 的re is no unified platform from physicians about surprise medical billing. Many physicians are finding they have little option but to contract with a staffing service that 合同 他们的服务延伸到医院. Hospitals then get a share of the profits from the care provided and obviously the most lucrative is out of network care.

最近的一次 暴露 by CBS news highlighted one case of a man who presented at an emergency room due to a recent MRI showing he had a very serious bulge in his spine. After an MRI he was told to go immediately to the emergency room or he could be paralyzed. Physicians in the emergency room indicated he needed emergency back surgery, which he had. 不久之后，他获得了650美元的奖金,000 bill for that surgery; his insurance company indicating the surgery was not medically necessary. This is a clear example of how the average person that may show up at an emergency room is willing to follow the advice of the physicians, without any kind of due diligence with the insurance company, 第二个意见, 等. 但这不是人类的本性吗? Imagine going to the emergency room with your young child and you are told that child needs an emergency procedure. My guess is you would likely proceed with little else in mind but your child’s health and wellbeing.

Now that you have a better understanding of what surprise medical billing is, 你能做些什么，我们能帮什么忙? 我们提供的服务被称为 Quizzify，其重点是提高卫生知识素养. 我们知道有健康知识的人 更低的医疗费用，更健康 比那些不懂健康知识的人.  In a recent post by the creator of Quizzify, Al Lewis, he highlights 六个 things employees should know about surprise medical billing. Quizzify is a fun and interactive way for employees to become health literate. If you are interested in learning more, please contact us at the 堪萨斯健康商业组织.

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