Assessment of Out-of-Network Billing for Privately Insured Patients Receiving Care in In-Network Hospitals.

ABSTRACT:

Importance

Although surprise medical bills are receiving considerable attention from lawmakers and the news media, to date there has been little systematic study of the incidence and financial consequences of out-of-network billing.

Objective

To examine out-of-network billing among privately insured patients with an inpatient admission or emergency department (ED) visit at in-network hospitals.

Design, setting, and participants

A retrospective analysis using data from the Clinformatics Data Mart database (Optum), which includes health insurance claims for individuals from all 50 US states receiving private health insurance from a large commercial insurer was conducted of all inpatient admissions (n = 5 457 981) and ED visits (n = 13 579 006) at in-network hospitals be

SUBMITTER: Sun EC 

PROVIDER: S-EPMC6692693 | biostudies-literature | 2019 Nov

REPOSITORIES: biostudies-literature