Balance Billing Nightmare: Are You at Risk for Surprise Medical Bills?

Posted on March 28, 2016 at 12:00pm by
Student debt defaults are on the rise.

Medical debts are still a major financial hindrance to families across the country, even for those with insurance. We have written about out-of-network hospital costs before, but more can be said about insanely high medical bills incurred by out-of-network health care specialists.

When health insurance companies narrow the number of providers available, consumers can be hit with huge medical bills through a process known as ‘balance billing’. Balance billing occurs when patients are treated by out-of-network health care specialists. Patients are left paying the difference between what their policies will pay and what the out-of-network specialists charge. What does balance billing look like?

Last year, The Atlantic wrote an article describing the story of a man who almost died from a heart attack walking his dog and had to make the difficult decision of which hospital to choose. The man and his wife knew several hospitals nearby were not covered by insurance. After finding a hospital covered by insurance, the man underwent emergency heart surgery and was hospitalized for a week.

Here’s the absurd part of the story. While most of the procedures were covered by insurance, the cardiac surgeon who operated on the man was out-of-network. Most of the bills received by the couple were for several hundred dollars, but the surgeon’s bill was $30,000. Insurance only paid for $4,000.

So there you have it, a person can be on the verge of dying or rendered unconscious, and be thrown into financial turmoil if the wrong doctor offers services, even in a hospital covered by insurance. It’s not like someone dying from a heart attack has the time to whip out his or her smartphone to start searching for which nearby doctors are in-network. Someone unconscious and on the way to a hospital certainly has no choice in the matter.

Balance Billing and Surprise Medical Bills

Balance billing happens to unsuspecting Americans every day and it can happen to you. In fact, a 2014 NerdWallet survey claims 63 percent of Americans have faced similar circumstances with varying degrees of severity. In most cases, balance billing occurs when patients receive services at in-network hospitals, but are treated by out-of-network health care specialists who can bill for the full price.

Most people cannot afford surprise health care payments worth the price of a brand new car. Until this problem is fixed, Americans will continue to be at risk for unaffordable surprise medical bills.

The Sader Law Firm and its Kansas City bankruptcy attorneys are dedicated to helping people start over financially by filing for bankruptcy.