Politics

Didn’t see that coming: Surprise medical bills draw scrutiny

AJC 2013 file photo: BOB ANDRES / BANDRES@AJC.COM
AJC 2013 file photo: BOB ANDRES / BANDRES@AJC.COM
By Michelle Miller
Oct 12, 2015

It’s called “balance billing,” but what it does is knock consumers off their feet.

Here’s what happens:

A patient scheduled for surgery makes sure the hospital and the surgeon are in the patient’s health plan network. But after the surgery, a surprise bill arrives for hundreds of dollars.

Turns out the anesthesiologist was not in the patient's insurance network, and the patient had no idea. Too bad. The patient owes the balance.

Faced with constituents complaining of medical debt, medical-bill-related bankruptcies and credit rating downgrades, a state legislative panel held a hearing recently about surprise billing for medical care.

Physicians and members of the hospital and insurance industries testified and pointed fingers of blame.

“Without protections, consumers are left holding the bag,’’ said Beth Stephens of Georgia Watch, a consumer advocacy group.

But are protections even possible? Find out the root causes of the problem and the outlook for potential solutions on MyAJC.com.

About the Author

Michelle Miller has been an editor at The Atlanta Journal-Constitution since 2000, for the first decade as a newspaper copy editor, and thereafter as a story editor for digital platforms and print. She has been a journalist for more than 35 years.

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