Balance billing is becoming an increasingly common topic for health care reform conversations. High-deductible health plans and narrow provider networks are exacerbating balance billing issues—and increasing balance billing complaints from patients. However, balance billing creates a unique set of challenges for emergency physicians, who are required by EMTALA to treat all patients regardless of their ability to pay and whose patients are not always able to ensure a provider is in network before seeking emergency care.
In response to the article “20 Things to Know About Balance Billing” in Becker’s Hospital Review, ACEP President Jay A. Kaplan, MD, FACEP, contacted Becker’s to provided additional insights into the balance billing issue. A few of his key points were:
- Patients feel as though they receive surprise bills (the balance not paid by insurance), but Dr. Kaplan believes what should be surprising is their lack of coverage.
- Insurers are driving providers out of network with the low reimbursement. The insurance company then passes out-of-network rates on to their insured customers.
- A recent ACEP poll noted that seven out of 10 emergency physicians had seen patients who had delayed seeking care due to out-of-pocket expenses.
Visit Beckers Hospital Review to read the full list of “20 Things to Know About Balance Billing,” as well as Dr. Kaplan’s “5 More Thoughts on Balance Billing.”