Elective surgery's surprise medical bill risk
Illustration: Lazaro Gamio/Axios
Even patients who plan elective surgeries with in-network doctors at in-network facilities have a pretty good chance of receiving a surprise medical bill, according to a new JAMA study.
Why it matters: Surprise bills are a problem for the patients who receive them, but also for the system as a whole, as they drive up overall health care costs.
The study found that 20.5% of elective surgeries — procedures like hysterectomies and knee replacements — performed at in-network facilities and by in-network primary surgeons resulted in an out-of-network bill.
- These bills came from providers who patients usually have no hand in choosing, like surgical assistants, anesthesiologists and radiologists.
Details: These bills ranged, on average, from less than $100 to several thousand dollars, depending on the specialty and the procedure.
- The average potential balance bill was $2,011.
- The largest potential bills tended to be from surgical assistants and anesthesiologists, which also were the most frequent sources of out-of-network bills.
- The South and Northwest had particularly high rates of these bills.
Go deeper: We all pay for surprise emergency room bills