Even when Virginia patients make an effort to use medical services in their insurance networks, they might fail to avoid out-of-network charges during hospitalization. Many patients understand that costs could be higher from out-of-network providers, but they may not realize that unexpected medical bills can result when they use in-network hospitals. Hospital administrators often cannot answer questions about out-of-network professionals and laboratories providing services within their hospitals due to complicated insurance contracts.
Narrowly defined provider networks, network tiers and restrictive coverage add layers of difficulty that confuse both patients and hospitals. Changing models of reimbursement add to the unpredictable nature of medical insurance and billing. The system leaves many consumers unable to know if they will be receiving out-of-network bills before agreeing to services.
A study by the Health Care Cost Institute looked at over 600,000 in-network inpatient hospital admissions and discovered that surprise out-of-network medical bills confronted one in seven patients. Services from anesthesiologists topped the list of professional claims coming from outside of patients' insurance networks. Charges from laboratories that operated independently of the in-network hospitals produced many surprise bills as well.
Because medical bills often reach into the thousands or tens of thousands of dollars, the debt could overwhelm someone's finances. Add in the hardship of missing work due to a medical crisis, and a person might not be able to pay the bills. However, an attorney may present Chapter 7 bankruptcy as a solution. Legal counsel could evaluate a person's eligibility for bankruptcy protection from bill collectors. To seek the discharge of medical debts, an attorney could prepare the financial disclosures and petitions for the bankruptcy court. A thorough disclosure of income and debts could prevent court delays and lead to a fresh financial start.