Medical specialties with the largest share of out-of-network bills for in-network hospital admissions

Among specialties, independent labs most often sent out-of-network bills as part of in-network hospital admissions in 2016, according to a report from the Health Care Cost Institute.  

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For the report, the institute used its commercial claims database to examine about 620,000 in-network inpatient admissions and associated professional claims (both in- and out-of-network claims filed by the physician or other healthcare professional who provided care) in 37 states and the District of Columbia in 2016.

To determine the prevalence of out-of-network billing by medical specialty, they examined which specialties most often sent out-of-network bills as part of in-network hospital admissions.

Here are the specialties that most often sent out-of-network bills at in-network facilities, based on the percentage of professional claims for each specialty that were out-of-network in the studied year.

Independent lab — 22.1 percent

Emergency medicine — 12 percent

Specialty not available — 11.5 percent

Other physician — 9.4 percent

Anesthesiology — 7.9 percent

Access the full report here.

 

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