Disputes Between Insurers and Hospital Puts Consumers in the Middle

By Consumers For Quality Care, on October 20, 2021

According to KHN, billing disputes between large health insurance companies and hospitals, exacerbated by the COVID-19 pandemic, have put consumers in the middle. Consumers now fear they will ultimately be on the hook for unresolved claims.

Hospitals are saying that large insurers are billions of dollars behind on owed payments or are issuing more denials of claims for emergency care.

These delays and denials in payments to hospitals put patients in a difficult position. They are left to wonder if they will be stuck paying the bill, and sometimes, they are. Hospitals might charge patients for treatments they thought were covered by insurance, or even sue patients when insurers don’t pay.

Alexis Thurber, a breast cancer patient who received an $18,192 bill for radiation therapy that doctors said was essential, was initially told by her insurer that the procedure would not be covered. Alexis spent the summer pleading with her insurer, causing immeasurable stress and worry. “It makes me not want to go to the doctor anymore,” she said. “I’m scared to get another mammogram because you can’t rely on it.”

Consumers have enough to worry about when it comes to their medical care. Insurers and hospitals must do better to resolve medical claims as quickly as possible, and never put consumers in the middle of billing disputes.