没有惊喜法案:放射学的法律挑战和影响
Joshua A Hirsch1, Karen Buch2, Kathryn Keysor3
1Vice Chair of Procedural Services, Director of Interventional Neuroradiology, Chief of Interventional Spine, and Associate Department Quality Chair, Department of Radiology, Division of NeuroInterventional Radiology, Massachusetts General Hospital, Boston, Massachusetts; and Councilor SNIS, Chair of Future Trends Committee, and Chair of Academic Committee, ACR, Reston, Virginia.
Journal of the American College of Radiology : JACR
|November 3, 2023
概括
意外的医疗费用是由于网络之外的意外费用而产生的. 医疗保健动态的变化影响了提供者与保险公司的谈判,影响了患者的成本.
科学领域:
- 医疗保健经济学 医疗保健经济学
- 医疗计费实践 医疗计费实践
背景情况:
- 意外的医疗账单往往是由于患者从其保险网络之外的提供者或设施获得护理.
- 这些意想不到的费用可能会导致患者的自付费用显著增加.
研究的目的:
- 探索惊喜医疗账单背后的复杂性.
- 检查放射学团体与保险公司之间不断变化的关系.
主要方法:
- 分析医疗保健提供者与保险公司之间的历史和当前合同动态.
- 审查影响保险网络组成的因素.
主要成果:
- 提供者与保险公司之间的传统动态发生了转变.
- 保险公司对更窄的网络的历史偏好影响了计费结果.
结论:
- 了解供应商合同和保险网络策略的复杂性对于应对意外医疗账单至关重要.
- 不断变化的环境需要对医疗保健支付谈判进行重新评估.
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