Out-of-Pocket Costs and Surprise Billing in Otolaryngology: A National Database Analysis.

ABSTRACT:

Objective

To evaluate out-of-pocket (OOP) costs and surprise billing (unexpected charges from out-of-network providers) in otolaryngology.

Study design

Retrospective cohort study.

Setting

National commercial claims database.

Methods

Merative MarketScan database was queried for commercially insured patients aged 18 to 64 who underwent any of six otolaryngology procedures (thyroidectomy, parotidectomy, hypoglossal nerve stimulator implantation, drug-induced sleep endoscopy, septoplasty, or tonsillectomy) from 2014 to 2022. OOP costs were defined as the sum of deductibles, copays, and coinsurance for each 30-day surgical episode. A potential surprise bill was defined as an out-of-network claim within an episode where both the primary surgeon and facility were in-n

SUBMITTER: Lenze NR 

PROVIDER: S-EPMC12661487 | biostudies-literature | 2025 Dec

REPOSITORIES: biostudies-literature