Surprise Balance Billing
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What is Surprise Billing?
Experts from the USC-Brookings Schaeffer Initiative for Health Policy answer commonly asked questions about surprise medical bills and how to deal with them at a policy level.
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Arbitration Over Out-Of-Network Medical Bills: Evidence From New Jersey Payment Disputes
Arbitrators seemed to anchor decision around surprising billing to the 80th percentile of charges with the median decision being 5.7 times prevailing in-network rates for the same services.
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Arbitration Decisions in New Jersey Surprise Billing Cases Result in Large Payouts
The mean award was 9 times higher than the median in-network price for the same services.
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High Air Ambulance Charges Concentrated in Private Equity- Owned Carriers
Private equity firm-owned air ambulance services charge markedly higher rates than other types of providers of the same service, according to new research.
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Our Experts On Surprise Balance Billing
Our Work In Surprise Balance Billing
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AJMC: Policies to Address Surprise Billing Can Affect Health Insurance Premiums
Policies to address surprise billing could reduce health insurance premiums by 1% to 5%.
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Out‐of‐Network Air Ambulance Bills: Prevalence, Magnitude, and Policy Solutions
Out‐of‐network air ambulance bills are a type of surprise medical bill and are driven by many of the same market failures behind other surprise medical bills.
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Study Finds Surprise Medical Bills Springing from Ambulatory Surgery Centers
One-in-twelve episodes at ambulatory surgery centers had the potential to result in a surprise medical bill, according to the study.
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Prevalence And Characteristics Of Surprise Out-Of-Network Bills From Professionals In Ambulatory Surgery Centers
One-in-twelve episodes at ambulatory surgery centers had the potential to result in a surprise medical bill, according to the study.
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How the Cares Act Affects COVID-19 Test Pricing
How will the CARES Act impact COVID-19 test pricing? One of our Schaeffer Initiative experts suggests a change to require insurers to pay for testing at Medicare prices and prohibit balance billing patients.
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Regulating Out-Of-Network Hospital Emergency Prices: Problem And Potential Benchmarks
Melnick focuses on the need and options to regulate hospital out-of-network emergency prices. Using data from California, he analyzes potential benchmarks for setting these prices.
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