Cases / Investigations

Surprise Medical Billing Investigation

Wolf Popper Is Investigating Consumer Claims that Patients Were Surprised By Medical Bills From Out-Of-Network Providers After Being Treated at In-Network Hospitals

If you were hit with a medical bill after an in-network hospital visit you may have a legal claim. Contacting an experienced medical bill lawyer could help you determine if you could get compensation for surprise expenses or unexpected out-of-network charges, at no cost to you.

Patients with insurance typically are charged one rate to go to in-network medical providers (such as hospitals and physicians) and are charged a higher rate to go out of network. Most patients are aware of the distinction between the two groups of providers and actively try to use in-network services to save money.

However, many patients are discovering that they get hit with surprise, out-of-network charges even though they used an in-network provider. Patients logically assume that a doctor at an in-network hospital will be in-network to the same insurance as the hospital, but this isn’t always the case, and often patients are unaware of this until they receive an unexpected and costly out-of-network medical bill. These surprise bills are known as balance bills because the medical providers charge patients the difference between their higher out-of-network rates and the amounts paid by insurance, or the “balance.” 

In many cases, surprise billing occurs when a hospital contracts with a physicians group to provide medical services at the hospital, but the contracted medical group does not accept the same insurance as the hospital and does not disclose that fact. The patient gets billed by the hospital for these charges, at an in-network rate, but gets billed separately for services provided by the physicians group, at their out-of-network rates.

Many hospitals contract with physicians groups to staff their emergency departments.  After receiving treatment, many patients receive a large bill from a physician’s group that they never heard of, one that often doesn’t take their insurance, even if the hospital they went to was in-network and they weren’t properly warned that this this would happen.

Patients are fighting back against these practices by bringing class action lawsuits in appropriate situations, such as when there is no warning that the physicians in the emergency departments are not in-network and will send them a bill, often an enormous one, after their visit.

Insurers, as well as patients, are beginning to fight back against contractors jacking up prices for hospital patients. Recently, UnitedHealth created a website that advertises the billing policies of Envision Healthcare, a contractor that runs UnitedHealth’s emergency services. UnitedHealth is reportedly attempting to renegotiate pricing contracts for Envision’s services to get a better deal for their patients.

Join a Free Surprise Medical Bill Class Action Lawsuit Investigation

If you were hit with a surprise medical bill from an out-of-network doctor at an in-network hospital, you may be entitled to compensation. Contact us for a free case evaluation.

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