Surprise Medical Bills Are a Problem, Say Emergency Room Doctors

Emergency room doctors recently added their voices to those of consumers who are increasingly outraged over surprise medical bills.

According to a piece published in Vox Media, The American College of Emergency Physicians (ACEP) have come up with a preliminary six-point proposal, which they plan to present to the U.S. Congress soon. Their plan comes in the wake of Senate bills from both sides of the aisle that are intended to address what is acknowledged to be a growing problem.

The Problem of Surprise Medical Bills

Unexpected medical expenses arise from what is known as “out of network insurance billing.” These surprise medical bills can wreak havoc on a person’s finances and credit, and the situation is not improving for consumers. This happens because while a person with a medical emergency may be taken to a hospital that is technically “within” an insurance company’s network, the emergency room itself may be managed by an out-of-network contracting company – and the physicians employed there would therefore be employed by that company.

There have been instances in which private management companies take unfair and questionable advantage of situations in which a patient lacks coverage by billing for as much as 300 percent or more. Unfortunately, this issue affects as many as 20 percent of emergency room patients.

Unexpected Charges Spark Lawsuit

One management company, known as EmCare, was reported as charging a 975 percent markup for an emergency room visit. EmCare’s parent company, Envision Healthcare, recently lost its contract with United Healthcare because of reports of “egregious billing practices” and is currently involved in litigation with its former client.

A story published in Forbes last year reported the case of a man who was taken to an emergency room in April, 2014 for a facial injury, believing he was covered. Instead, the attending physician was employed by Emcare – and the man received an “out-of-network” bill for over $2250.

In a class action against Envision, the plaintiff claimed the company has “…implemented a deceptive and unlawful corporate scheme whereby Defendants’ physicians hide behind the veil of the hospital’s network.”

“U.S. Healthcare at its Ugliest”

According to the Forbes article, Envision is the largest company today involved in the outsourcing of doctors to hospitals, controlling six percent of the $41 billion emergency care market. Envision has drawn scrutiny from Congress over allegations of overbilling. In December, 2017, the company paid $30 million to the U.S. Department of Justice to settle charges of providing their doctors with financial incentives to admit patients when they had no authority to do so.

Not Limited to Emergency Care

The problem of surprise medical bills does not only happen because of emergency room visits. Patients may also receive unexpected bills for lab tests or specialty services such as x-rays and anesthesia, as these are often outsourced as well.

Because the problem has gotten so widespread, the ACEP has laid out a specific plan to protect healthcare consumers and insure that emergency patients will receive treatment, regardless of ability to pay and are not penalized for needing emergency care.

In the meantime, those who receive unexpected medical bills may qualify to participate in a medical billing class action lawsuit that could result in compensation for many affected patients.

Join a Free Surprise Medical Bill Class Action Lawsuit Investigation

If you were hit with a surprise medical bill from an out-of-network doctor at an in-network hospital, you may be entitled to compensation.

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