Nearly 1 in 8 patients receive unexpected out-of-network bills after colonoscopy

https://www.eurekalert.org/pub_releases/2020-10/acop-n1i100620.php

News Release 12-Oct-2020
American College of Physicians

Nearly 1 in 8 commercially insured patients nationwide who underwent an elective colonoscopy between 2012 and 2017 performed by an in-network provider received potential "surprise" bills for out-of-network expenses, often totaling hundreds of dollars or more. These findings are concerning, as federal regulations eliminate consumer cost-sharing when screening colonoscopies are performed in-network. A brief research report is published in Annals of Internal Medicine.

Researchers from the University of Virginia and the University of Michigan reviewed 1.1 million claims from a large national insurer to estimate the prevalence, amount, and source of out-of-network claims for commercially insured patients having an elective colonoscopy when all of the endoscopists and facilities were in-network. The researchers found that 12.1 percent of cases received out-of-network claims, with an average surprise bill of $418. The bills often came because of the use of out-of-network anesthesiologists and out-of-network pathologists. 

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