Were You Charged an Out-Of-Network Medical Bill?

A class action lawsuit investigation is looking into claims by patients who claim they were unexpectedly charged an out-of-network medical bill.

Insurance companies have a common practice of charging different rates for policy holders to use “in-network” services, physicians, and facilities as opposed to “out-of-network” versions of the same. Networks are determined primarily on a patient and provider’s location, and to go “out-of-network” usually means racking up higher medical bills.

Patients often intentionally choose in-network services over out-of-network services to keep their medical bills low. Many patients assume that if they choose an in-network hospital or clinic, that services and staff within that facility will also be in-network. However, many patients discover that this is not the case, when they receive a medical bill that charges for out-of-network services.

According to a study by the Yale School of Public Health and the Yale School of Management, surprise medical bills incurred from the use of out-of-network providers run patients an average of over $622. Reportedly, being hit with an out-of-network medical bill is a problem experienced by 22 percent of emergency room patients.

Patients in a number of scenarios can find that they are being charged an out-of-network medical bill. In most cases, patients are not alerted ahead of time that an out-of-network care provider is being called in, or are not given a choice of having an in-network versus out-of-network provider.

Situations in which patients can find the themselves unexpectedly charged for an out-of-network service or doctor include the following:

1. A patient who calls 911 may have to pay for an out-of-network ambulance service that was contracted by emergency services. These services often charge by the mile, as well as charge for every service provided during the ride. Patients often find that their insurance does not cover these rides.
2. Patients who have a surgery performed at an in-network hospital may be notified that their surgeon is also in-network. However, an anesthesiologist or assisting physician may be brought in during the procedure. These other medical professionals may be out of network, and the patient may not be notified until they receive the medical bill for the procedure. This often happens because anesthesiologists often don’t work directly for the hospital, and are contracted in.
3. A patient who goes to the emergency room at an in-network facility may be treated by an out-of-network ER doctor and billed for an out-of-network service. Like anesthesiologists and radiologists, ER doctors are often contracted by hospitals, as opposed to being directly employed by them.

Lawyers are investigating patients’ claims of hospitals and insurance claims hitting them with a surprise out-of-network medical bill. Patients are often blindsided by this practice, and feel that they were not adequately informed of the costs their treatment. An out-of-network medical bill lawsuit can help patients recuperate damages from financial injury incurred by a surprise out-of-network medical bill.