The 5 types of doctors most likely to send you a “surprise” medical bill

February 14, 2017

medical bills health care costsYour son needs stitches, so you visit the emergency room at a hospital in your health insurance network. Thirty days later you get a bill from the doctor who treated your child. But the doctor wasn’t part of the network and you face a hefty charge.

This falls into the category of “surprise” medical bills. They often result from emergency situations, when consumers have no warning and little choice of care. Or when your primary doctor calls in an out-of-network specialist or sends your biopsy to an out-of-network laboratory. And now you owe far more than you expected.

Researchers at Johns Hopkins University examined these “surprise” charges and published their results in the Journal of the American Medical Association. The study of more than 400,000 doctors with 54 specialties found the average anesthesiologist, radiologist, emergency physician, pathologist and neurosurgeon charge at least four times more than what Medicare reimburses. The Medicare reimbursement rates matter because insurers typically use them as a starting point when they decide how much they will reimburse patients treated outside their insurance network.

There’s growing agreement that consumers need more protections from “surprise” bills.

“These are not doctors you typically choose,” Gerard Anderson a professor at the Johns Hopkins Blomberg School of Health told Consumer Reports.

On the other side of the ledger, the  study found the doctors with the lowest markups are the ones people see most often: general practitioners, psychiatrists, allergists, immunologists, dermatologists and family practitioners.

Have you or someone you know received a “surprise” medical bill? Share your story with Voices for Affordable Health.