5 Key Ways to End Surprise Medical Bills

Geraldine Slevin
Assistant Policy Analyst

Friday, November 20th, 2015


Since we launched our efforts to stop surprise medical bills, we’ve been asking you for your stories about unexpected bills you’ve received from out-of-network doctors. We know surprise bills are a huge problem: one-third of respondents to our survey reported receiving a bill where insurance paid less than expected. We’ve received stories totaling almost $7 million in bills, and that’s only a tiny fraction of all the people who’ve received surprise bills nationwide.

We’ve talked with policymakers, regulators, and consumer advocates in states across the country to learn which protections are already in place – and which loopholes leave consumers vulnerable to financial strain, debt, and even bankruptcy.

Last week, we released a guide for advocates identifying practical steps for addressing this problem, including five essential protections against surprise medical bills. In the report, we highlight five essential protections against surprise medical bills:

  1. An obligation for insurers to maintain accurate and up-to-date provider directories, with auditing and consequences for non-compliance
  2. A requirement that providers inform consumers whether they are in-network or out-of-network in a way that preserves meaningful consumer choice
  3. A ban on “balance billing” that explicitly protects the consumer from receiving or having to pay unavoidable or inadvertent out-of-network charges, known as balance bills
  4. A well-defined process for determining payment of surprise bills, including some type of independent dispute resolution process; and
  5. An effective way of informing consumers of their surprise bill rights.

The solutions are clear – now we just need policymakers and consumers like you to help us make change happen. We’re partnering with state advocates across the country to gather stories and press legislators to act, and we will need your help to pile on the pressure!

Take a look at the report – and take action! Thousands have already signed our petition demanding that policymakers protect them from unfair, unexpected bills. Sign on today to help us end surprise medical bills for good!

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One response to “5 Key Ways to End Surprise Medical Bills”

  1. I was surprised to learn that consumers are not immediately informed that they are in or out of network. Consumer choice is one of the most important aspects of our economy. After reading this article hiring a medical advocate seems like a very good idea.

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