Industry News

Out of Network Providers in Hospital Settings

A recent article from Modern Healthcare reports that about 1 in 7 Illinois patients who were admitted to an in-network hospital received at least one medical bill as the result of being seen/treated by an out of network provider while in the hospital. Anesthesiology and independent labs were the most likely to bill as out of network entities, at 16.5% and 22.1% respectively. According to the Health Care Cost Institute’s analysis of 620,000 in network admissions and associated claims from 37 states, the out of network incidence ranged from a low of 1.7% in Minnesota to 26.3% in Florida (Illinois came in at 15%).