Though much maligned in the press and the subject of legislation in a number of states, “surprise” bills are still an issue for patients after a trip to their local emergency room. In fact, a new study by Yale researchers published in the New England Journal of Medicine reveals that nearly a quarter of in-network ED visits can be followed by a bill from an out-of-network doctor. The authors considered claims for more than 2 million visits around the country. Patients might be liable for an average balance of around $622, they estimate. It was not clear from the data many patients were victims of a surprise bill. Surprise bills usually follow a hospital visit during which the patient was seen by hospital-based specialists, especially radiologists and anesthesiologists, who are contracted by the hospital as opposed to being employed directly by the hospital. This practice is more prevalent in some communities than in others; in McAllen, TX, for example, nearly 90% of ED visits involved out-of-network doctors, while in Boulder, CO and South Bend, IN, nearly none did.

Yale Study Shows ‘Surprise’ Bills Still Common After a Trip to the ED
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