Many consumers surprised at insurance bills, report finds
Almost 33 percent of individuals enrolled in a private health plan have received surprise medical bills in the past two years, according to a new survey from Consumer Reports.
After surveying about 2,200 people, Consumer Reports determined that almost one out of every three individuals didn't expect to get a bill from their insurer. Of those who received a surprise medical bill, almost one out of four people said it was from a doctor they didn't expect to get a bill from.
"Even if you go to a hospital in your network, the unfortunate truth is that there is no guarantee that all your treatment--whether it's the radiologist, anesthesiologist or lab work--will be treated as in-network, leaving patients owing thousands of dollars they never anticipated," DeAnn Friedholm, director of health reform for Consumers Union, the policy and advocacy division of Consumer Reports, said in a statement.
What's more, 62 percent of respondents said they're "very likely" or "somewhat likely" to complain about an unexpected bill.
But most consumers don't know whether or how they can fight these bills.
The survey found that almost 75 percent of respondents were unsure if they had the right to appeal a medical bill for services they believed their insurer should cover. Meanwhile, 87 percent of individuals didn't know which state agency was responsible for handling insurance complaints, so they didn't know where they should file a complaint.
"This survey clearly shows that consumers want to complain about bills, but don't know who to contact or even if they should be complaining," Friedholm said.
Data from the California insurance departments show that, when consumers do challenge a healthcare service their insurer denied, they win about half the time, FierceHealthPayer previously reported.
To learn more:
- here are the Consumer Reports statement and survey
Related Articles:
How payers can speed up the claims process
Consumers usually win when they appeal claim denials
CMS issues final rule on appeal rights for applicable plans
Medicare faces huge backlog of claims appeals
Comments