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FEBRUARY 9, 2017

Out-of-Network Billing: ‘Surprise Billing’ Or ‘Surprise Gaps in Insurance Coverage’?

Quality Queries and Quandaries:

Emil Engels, MD, MBA, CPC

By Emil Engels, MD, MBA, CPC

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This is a familiar story: A patient with health insurance has an accident and seeks care at a hospital. She receives care in the ER and undergoes an operation. The health care team provides the necessary care, regardless of her health insurance policy. After discharge from the hospital, she receives an unexpected bill from the ER, surgeon and anesthesiologist. Her family wonders why she received separate bills from her providers, because she