If you recently received an unexpected medical bill, you are not alone. The Consumer Reports National Research Center recently conducted a survey which found that nearly one-third of Americans with private health insurance received a surprise medical bill in the last two years. In most cases, patients went to a hospital within their insurance plan’s network, but were treated by a physician who had not contracted with the insurer.
Many privately insured Americans regularly face the issue of reimbursement, or lack thereof, for treatment by doctors outside their insurance plan’s network. Only 28% of privately insured Americans surveyed by Consumer Reports were satisfied with how such reimbursement was handled. Some 53% reported that billing issues were either not resolved as they would have liked, or not resolved at all. As many as 57% ended up paying the bill in full.
When someone thinks they need a medical service and their health plan denies coverage for it, they have the right to appeal to their state government or an independent medical expert. However, nearly three-quarters of privately insured Americans surveyed by Consumer Reports reported being unsure whether they had this right. Also, 87% reported that they did not know the agency or department responsible for handling health insurance complaints where they live.
Consumers Union, the advocacy and public policy arm of Consumer Reports, has developed an online tool you can use to look up the state government offices responsible for handling health insurance complaints where you live. Click here to take a look at the tool.
If you’ve recently received an unexpected medical bill, please also consider emailing a brief description of your experience to DPC Government Affairs Director Jackson Williams at firstname.lastname@example.org. Sharing your stories with policymakers will strengthen our advocacy efforts on behalf of dialysis patients across the country.