Your healthcare shouldn’t have surprises

Daniela Nuñez
Social Media Program Manager

Wednesday, September 23rd, 2015

You buy health insurance so there aren’t any surprises when it comes to paying for your medical care. Yet nearly a third of consumers say they’re getting a bill they didn’t expect! That’s exactly why we’ve launched the End Surprise Medical bills campaign — and you can help us end these unfair bills for good.

Why are surprise bills such a problem? Simply put, loopholes mean there is no guarantee that when you go to an ‘in-network’ hospital or medical facility, you’ll actually pay in-network prices. Picking a hospital on your insurance may still leave you with a big surprise if the anesthesiologist in the operating room isn’t covered on your plan.

You’re ultimately stuck between the doctor and your insurer, and with weak protections, you’re expected to pay the bill!
We’ve heard from a huge number of people who got hit with surprise medical bills following routine and emergency procedures. Our Consumer Reports survey found among those consumers with surprise bills, nearly one in four got a bill from a doctor they did not expect.

Your stories of outrage started this campaign rolling. They helped pass a groundbreaking New York law that holds consumers harmless from surprise out-of-network bills in emergency medical situations. Lawmakers in Connecticut recently passed similar legislation.

With those wins under our belt, we’re working to make sure every American is protected from surprise medical bills or has a clear path to fight them. In Texas, Michael Fryar testified about his emergency appendectomy that resulted in a $947 surprise bill from out-of-network providers. Because it was under $1,000, state law said he was ineligible for help to fight it. Stories like Michael’s helped push the Texas Legislature to lower the threshold for bill mediation to $500 — a big stride, with more work to be done.

We also just got a new law passed in California so residents there will have an easier time figuring out which doctors are in their insurance plans. The bill requires insurance companies to maintain accurate provider directories — a crucial step to avoid surprise bills.

We want to make sure you have protections too, so join our effort to end surprise medical bills. Take action by adding your name to the national petition. Share your surprise medical bill story to help bring attention to the problem in your state. Visit our Complaint Tool and share it with your friends and family so they know where to go for help. And join us on Twitter using #SurpriseMedBills.

View all Campaign Updates

5 responses to “Your healthcare shouldn’t have surprises”

  1. Dick Lambert says:

    Why not just pass a law that requires ALL medical providers to confirm that they are in the patient’s insurance network and make the providers responsible to get the patient’s permission to provide their service if they are not. If the provider fails to get the patients permission the provider would be responsible to work out payment with the patient’s insurance provider.

    • Kendall says:

      It really is that simple. In most cases (including mine) the provider still receives the in network rate. If they wish to bill beyond that, they should either pursue the insurance provider with a claim (and powerful evidence) justifying additional payment.

      If they can not make that claim, or do not want to, they should not be working as contractors in hospitals that do business with such insurance companies.

      At the absolute least, they should require additional paperwork that clearly notifies the patient that they do not accept said insurance, and will bill the patient directly. I do not know but if the patient refuses obligation, but the provider is working as a contractor in the er, they may be required by oath to service the patient. But once again, if that is a problem, they should avoid working as a contracted ER employee.

      It really does seem like a game of hot potato, where the person stuck with the potato is usually the one who doesn’t even know about the game being played (and the one in the room with the least individual influence).

  2. Brian says:

    FYI unable to fill out form for petition after clicking link from consumer reports,will not allow characters to be entered. I found another link enter info..

  3. Tim Wright says:

    Why is the “End Robo Calls” photo attached when I try to share this on Facebook?

  4. David Bowman says:

    in case you hadn’t seen this…

    Politico Pro: Docs Battle Proposal To Curb ‘Surprise’ Medical Bills
    A contentious fight over “surprise” medical bills is complicating an effort to revise a longstanding model state law on health care provider networks. The American Medical Association and other physician groups are pushing the National Association of Insurance Commissioners to drop draft language addressing what happens when patients visit facilities that are in their insurance networks but receive treatment from out-of-network providers. (Demko, 9/24)

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