AHIP Takes Shot Across the Bow at Out-of-Network Payments

The America’s Health Insurance Plans has commissioned a report which, not surprisingly, claims some out-of-network physicians are charging patients fees as high as 1,000 percent of Medicare reimbursements for the same service in the same geographic area.

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For example, the report, produced by Washington-based consultant Dyckman & Associates, claims that a physician in one state billed a patient $6,791 for “cataract surgery with insertion of artificial lens,” which is 1,100 percent of the Medicare fee of $581.

AHIP noted that the issue of appropriate for out-of-network fees has not been part of the debate to reform the nation’s healthcare system, but added that it should be.

Read AHIP’s release on the report on out-of-network charges.

View the out-of-network charges report (pdf).

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