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EMPLOYEE BENEFIT VIEWS
An excerpt from our Employee Bene t Views blog, written by Loretta Metzger, bene ts consultant at Corporate Synergies, an employee bene ts brokerage and consultancy.
Preparing employees for surprise medical bills
When employees get sick or injured, the last thing they need is a jolt to the heart when medical bills start rolling in. Yet surprise bills are becoming more common.
As an employer, you might feel powerless to help an employee deal with a nancial blow of hundreds or even thousands of dollars. But you can help, or rather, there are specialized employee advocacy centers that can o er assistance.
e doctors who charge the most are typically those that a patient did not choose. A seriously ill or injured person who is rushed to the emergency room may not be in a position to check if the anesthesiologists, ER physicians, neurosurgeons, pathologists and radiologists are all in-network. Researchers from the Yale School of Public Health and the Yale School of Management reviewed more than 2 million ER department visits and they found that one in ve patients who used in-network emergency room facilities were actually treated by an out-of-network doctor. is exposed patients to additional, and sometimes huge, charges that were not covered by their medical plans.
A recent study in the Journal of the American Medical Association found that the average physician charges about two-and-a-half times what Medicare pays, while some charge up to four times more. Insur- ers typically use Medicare payments to determine what they will reimburse patients. Out-of-network physicians referred by the in-network doctor also drive high costs.
e problem of surprise medical bills is becoming a fact of life for many employees, as insurance networks narrow and eliminate coverage for out-of-network services in an e ort to save costs. is can put employers in a tough spot. Employees could get stuck with a hefty medical bill several weeks — or even months — after getting care. en they come to HR or their bene ts department for help deciphering a bill or a complicated explanation of bene ts statement.
Bene ts advocacy services are often provided by health insurance brokers. A strong employee advocacy program can help employees navigate a high medical bill and even intercede to reduce a bill for emergency healthcare services. Bene ts advocates can also help participants review their insurance plans before a procedure to determine what the plan will pay.
To read this blog in its entirety, check out http://bit.ly/2rGZb1J.