By Donna King
Carolina Journal News Service
RALEIGH — A measure that would require a healthcare facility to notify patients of any out-of-network care they receive is moving through the Senate. Senate Bill 505, comes amid patient complaints that an out-of-network provider would participate in their care, often without seeing the patient, resulting in a hefty surprise bill weeks later.
The Senate Health Care Committee approved “Medical Billing Transparency” which would require that patients be notified 72 hours beforehand of who is participating in their case and an estimated cost of services. In the case of an emergency, it requires notification as soon as possible.
“In an emergency, the last thing on someone’s mind should be whether or not the anesthesiologist preparing them for surgery is in or out of their network,” said bill sponsor Sen. Joyce Krawiec (R-Forsyth). “Yet, we know far too often someone is saddled with a surprise bill after receiving care because of that very scenario. This legislation gives patients the necessary information to make the best decision about their healthcare and how much it’ll cost them.”
In many cases, the hospital and its employees might be in-network, but a provider working there is contracted, billing separately through their own company. If that company is not in-network, studies have shown that their bills are often “2.5 times what most health insurers pay and more than 3 times what hospitals’ actual costs.”
In research published in the New England Journal of Medicine more than one in five patients experience surprise billing and the average out-of-network bill is $900. A study conducted by the Journal of Public Health found that two-thirds of people who declared personal bankruptcy cited medical bills as a primary reason.
The bill will now go to the Senate Commerce and Insurance Committee for another hearing.