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out-of-network charges

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Hospitals in middle in fights over out-of-network charges

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“The most stressful part for hospital officials, who often serve as mediators between insurers and out-of-network physicians, is getting physicians to come to the table. ‘The plans have been amenable to contracting with our hospital-based physicians,’ Rudy Braccili, executive director of revenue-cycle services at Boca Raton (Fla.) Regional Hospital, told Mr. Herman. “Of course, it’s a two-way street. The physicians have to be willing to accept the rates plans offer them. Sometimes that’s a little bit more of a challenging conversation.”Mr. Herman wrote: “A growing number of hospitals and insurers are setting up processes to resolve out-of-network bills before the problem escalates into a public relations disaster that could undermine support for narrow-network plans. But eliminating surprise bills altogether may require broader business changes by healthcare organizations and/or regulatory action by policymakers. ”


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