Physician Practice

Out-of-network bills a bigger problem

Physician Practice Insider, November 15, 2016

Federal healthcare reform has changed the healthcare landscape, but not always for the better. One post-healthcare reform problem that has gotten worse is out-of-network billing. With insurers engaged in a never-ending process of adjusting provider networks in search of better coverage and lower costs, providers have been moved around at an unprecedented rate.

“It’s absolutely become a bigger problem during the past few years,” says David Zetter, a healthcare management consultant and president of Zetter Healthcare in Mechanicsburg, Pennsylvania. “You have health plans dumping more and more physicians as they alter their networks, and that creates more confusion for doctors and their patients.”

Zetter says the problem is creating a situation where physicians and patients need to double-check every physician and facility when they make patient referrals to avoid mistakes.

“Physicians have to be attentive to patient satisfaction now more than ever,” says Zetter. “So out-of-network bills could result in losing patients.”

This article was originally published in Physician Practice Perspectives. Subscribers can read the full article in the September 2016 issue.

Most Popular