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Sep
11

American Journal of Managed Care: Policies to Address Surprise Billing Can Affect Health Insurance Premiums

 Abstract:  Objectives: To quantify the proportion of health plan spending on services for which surprise billing is common—provided by radiologists, anesthesiologists, pathologists, emergency physicians, emergency ground ambulances, and emergency outpatient facilities—and estimate the potential impact of proposed policies to address surprise billing on health insurance premiums. Study D...
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Nov
25

Health Affairs: Surprise Bills, Benchmarks, And The Problem Of Indexation

​HCCI data was cited in a Health Affairs blog article on surprise billing.   From the Article: "Over the past year, the congressional debate over surprise billing has converged on two policy options to resolve out-of-network payments—1) a simple benchmark, in which a health plan pays out-of-network providers the median rate agreed with local in-network providers in the same specialty, or...
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Nov
21

How common is out-of-network billing?

Congress is considering legislation to address "surprise bills", which occur when a person visits an in-network facility, but receives services from a provider that is outside of their insurer's network. Bills in both the House and Senate include provisions to determine a benchmark rate for out-of-network payments based on what in-network providers of the same specialty are paid for delivering sim...
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Aug
12

Health Affairs: Surprise Billing: Choose Patients Over Profit

 HCCI's research on median in-network rates was recently featured in a Health Affairs blog post on surprise billing. From the blog: "Most importantly, Congress should establish a locally based benchmark to determine the amount an insurer would be required to pay a provider for a surprise bill. Ideally, we'd set the benchmark at some multiple (for example 125 percent) of what Medicare pays to ...
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Jul
23

Comparing Commercial and Medicare Rates for Select Anesthesia, Emergency Room, and Radiology Services by State

Committees in both the House and Senate have advanced legislation that includes measures to address "surprise bills." A surprise bill results when a person unknowingly receives medical care from a provider that is not part of their insurer's network. Both pieces of legislation set a benchmark for out-of-network payments. Those benchmarks are determined based on the median in-network amount paid by...
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Apr
17

CBS Evening News: Family Hit With $3,700 Bill For Out-Of-Network Anesthesiologist

HCCI's research on out-of-network billing was recently cited by a CBS Evening News report on the topic. Family hit with $3,700 bill for out-of-network anesthesiologist - CBS News When Adam and Laura Parkinson chose their hospital and obstetrician for the birth of their son, they didn't think they would get hit with a surprise bill for the epidural https://www.cbsnews.com/news/out-of-netwo...
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Mar
28

Surprise out-of-network medical bills during in-network hospital admissions varied by state and medical specialty, 2016

 Out-of-network billing practices have increasingly garnered attention as individuals with commercial health insurance continue to experience "surprise billing." A surprise medical bill commonly describes a charge to a patient for care delivered by an out-of-network (OON) professional who works within an in-network facility. We used the Health Care Cost Institute's (HCCI) vast commercial...
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