METHODS We analyzed data from the Clinformatics DataMart (Eden Prairie, MN) on
commercially insured patients undergoing 1 of 4 common elective orthopedic procedures …

Background: Out-of-network charges during hospital care can result in unexpected or
surprise bills for the patient. The aim of this study was to ascertain the frequency of out-of …

Importance Privately insured patients who receive care from in-network physicians may
receive unexpected out-of-network bills (“surprise bills”) from out-of-network clinicians they …

“Surprise” billing occurs when patients with health insurance receive care from a clinician or
facility included in their insurer's network (“in-network”) but unexpectedly receive “surprise” …

Background: Markups on charges for medical services have the potential to result in
“surprise billing,” especially for out-of-network and uninsured patients. Although previously …

Objective: To describe patterns of postoperative visits reported for Medicare fee-for-service
(FFS) patients. Background: Payment for most surgical procedures bundles postoperative …

Surprise billing occurs when insured patients receive unexpected out-of-network charges
and fees even when the emergency department, facility, or primary physician who provided …

Background With increased policy emphasis on shifting risk from payers to providers
through mechanisms such as bundled payments and accountable care organizations …

Although used interchangeably, balance billing and surprise billing represent distinct
scenarios. Balance billing implies that a patient is billed directly by a provider for the …

In April 2016, the Centers for Medicare and Medicaid Services (CMS) enacted a major policy
change by mandating for the first time that providers participate in an alternative payment …