NCHC: Surprise Medical Billing Primer

Surprise medical billing contributes to unpredictable, high out-of-pocket costs for consumers. Patients often encounter surprise medical bills when receiving emergency or ancillary health services from out-of-network practitioners. Recent studies indicate that surprise billing is concentrated in specific specialties like pathology.1 These providers “balance bill” patients for the difference between the full charge for services and the amount paid by the insurer, or bill for the entire amount of undiscounted charges. Payers, providers, facilities, and health consumers are all stakeholders to consider in legislation to address surprise medical bills. In protecting consumers, policymakers should not fuel health care inflation, but rather, promote reasonable solutions that appease payers, providers, and patients. See the Coalition’s full primer here.