Surprise medical bills are stacking up for many adults | PBS NewsHour

One out of three American adults who have private health insurance coverage nevertheless receive what “Time Magazine” calls a “surprise” medical bill, according to a survey conducted by “Consumer Reports”. The unwelcome surprise is for procedures they think are covered by insurance but are not, ranging from a few hundred dollars for an emergency room visit to tens of thousands of dollars for an operation. Reporter Haley Sweetland Edwards wrote the story “You Only Think You’re Covered” for this week’s issue of “Time Magazine” and she joins me now from Miami to discuss it. So, what is the trap that people are getting caught into? You basically break it down to this in-network versus out-of-network chasm. HALEY SWEETLAND EDWARDS, TIME MAGAZINE REPORTER: Right. So, people will go to an in-network hospital, see an in-network provider, and over the course of that medical visit, interact with other medical providers who are out of network. So, an in-network hospital will contract with out-of-network providers — radiologists, anesthesiologists, lab technicians. All of those people, even though they’re working at an in-network hospital, can be out of network and often are. HARI SREENIVASAN: There’s no way for a consumer to know when you walk in who is in network. It’s not like they’re wearing different colored uniforms? HALEY SWEETLAND EDWARDS: Right, right. And even when patients ask ahead of time, they say, you know, “I’m going in for this procedure, is my doctor in network, is my anesthesiologist in network?” They don’t know to ask other questions like, is the consulting surgeon on duty that day who may or may not be in the operating theater, is he also in network? HARI SREENIVASAN: Now, the Affordable Care Act is supposed to make it, that as you say in the story, if I break my arm and I go the ER, I’m supposed to basically get in-network rates. But that’s not the whole story.

Source: Surprise medical bills are stacking up for many adults | PBS NewsHour


Author: Stephen G. Barr, Group Publisher

Author, Syndicated Columnist, Editor In-Chief and Group Publisher at SGB Media Group, a social media marketing firm specializing in digital media content production, publishing, affiliate marketing, public relations and advertising. Over 25 years experience in retailing, advertising, website & online forum development, niche social networking, affiliate marketing, search optimization, branding and identity, site location, non-profit fund raising. Event planning, promotion, production and MC/Host at public events. Author, Editor & Publisher of 35 syndicated, digital publications utilizing multiple digital distribution channels in conjunction with launching and administrating national advertising campaigns for major Fortune 500 advertisers in partnership with Google, Ning, Facebook, Myspace, Yahoo, DoubleClick, LinkShare, PepperJam and other industry leading third party affiliate networks. Product development team member from conception to launch on many websites, tangible goods and organizational structure for start ups. Specialties: Public relations, retailing, advertising, website & online forum development, niche social networking, blogging, email campaigns, affiliate/performance marketing, search optimization, branding and identity, site location, event production & promotion, non-profit fund raising and tasteful, responsible adult content publishing. An internationally recognized and read social media columnist & pundit on The Examiner, Associate Content,, and Technorati and his own affiliated sites.