Quantifying Balance Billing for Out-of-Network Behavioral Health Care in Employer-Sponsored Insurance.

ABSTRACT:

Objective

The study estimated balance billing for out-of-network behavioral health claims and described subscriber characteristics associated with higher billing.

Methods

Claims data (2011-2014) from a national managed behavioral health organization's employer-sponsored insurance (N=196,034 family-years with out-of-network behavioral health claims) were used to calculate inflation-adjusted annual balance billing-the submitted amount (charged by provider) minus the allowed amount (insurer agreed to pay plus patient cost-sharing) and any discounts offered by the provider. Among family-years with complete sociodemographic data (N=68,659), regressions modeled balance billing as a function of plan and provider supply, subscriber and family-year, and employer characteristics. A tw

SUBMITTER: Friedman SA 

PROVIDER: S-EPMC9444804 | biostudies-literature | 2022 Sep

REPOSITORIES: biostudies-literature