An anesthesiologist is reminding Tennesseans about protections under the federal No Surprises Act.
The law shields privately insured patients from unexpected bills when treated by out-of-network specialists.
Dr. Blake Daniels, an anesthesiologist at North American Partners in Anesthesia, noted patients usually have no choice in providers such as anesthesiologists or emergency room doctors. Before the No Surprises Act, many scheduled procedures at in-network facilities but still ended up with unexpected bills from out-of-network specialists such as radiologists or anesthesiologists.
Daniels said he is fully supportive of protecting patients from surprise medical bills.
"As an advocate for patients, fair billing and patient access are critical but they can't come at the expense of our health care providers," Daniels contended. "We need to ensure payment mechanisms are also fair and don't put additional stress on a hospital system and impair our ability to recruit and retain the doctors and nurses our community needs."
According to a recent survey, about 20% of adults with health insurance said they have unexpectedly been charged for medical services after receiving emergency care from out-of-network providers or being treated at in-network hospitals where some care was delivered by out-of-network professionals.
Daniels pointed out the bipartisan law shifts out-of-network billing to third-party firms such as MultiPlan, which use algorithms to set rates. He warned the payments are often too low, leaving specialists underpaid, even when patients go to in-network hospitals.
While patients are only on the hook for in-network costs, he pointed out the law raises tough questions about how emergency room doctors, anesthesiologists and others will stay afloat.
"Protecting patients from surprise bills is essential," Daniels emphasized. "But if we don't ensure a fair reimbursement for providers, we risk losing the very people who provide that care."
The survey also found after implementation of the No Surprises Act, out-of-pocket spending declined among privately insured adults in Tennessee, particularly those who buy their own insurance and gained billing protections for the first time.