Nationally, 20 percent of inpatient emergency department cases may lead to surprise bills, according to a new study by economists with the Federal Trade Commission.
The study, published in Health Affairs, describes a surprise medical bill as "a bill from an out-of-network provider that was not expected by the patient or that came from an out-of-network provider not chosen by the patient." In 2014, 20 percent of hospital inpatient admissions originating in the ED, 14 percent of outpatient visits to the ED and 9 percent of elective inpatient admissions "likely led to a surprise medical bill," according to the study.
The study, which examines data from insurance records from employer-sponsored plans, overall found ambulance rides may be one cause of surprise billing, reports the Houston Chronicle.
"When an ambulance is necessary, it is unlikely that you will have the time to consider your insurance network. In more than half of cases involving ambulance transportation, the ambulance services were out-of-network. For air and water ambulances, more than 60 percent were out-of-network," the study's authors wrote, according to the report. Additionally, the publication notes, the study found patients admitted after going to the emergency room are more likely to get a surprise medical bill than outpatient care.
This "implies that the chance of receiving an unexpected bill increases with the severity of the patient's injury. This is troubling because one objective of insurance is to provide more protection in situations that are extreme and costly," the study's authors said, according to the report.