Inaccuracies associated with use of out-of-network providers, surprise bills
MONDAY, June 1, 2020 (HealthDay News) — Inaccuracies in provider directories are associated with use of out-of-network mental health care providers and surprise bills, according to a study published in the June issue of Health Affairs.
Susan H. Busch, Ph.D., from the Yale School of Public Health in New Haven, Connecticut, and Kelly A. Kyanko, M.D., from New York University Langone Health in New York City, conducted a national survey of privately insured patients who received specialty mental health treatment to better understand the use of provider directories.
The researchers found that 44 percent of patients had used a mental health provider directory, and of those who used a directory, 53 percent encountered directory inaccuracies. Individuals who encountered inaccuracies were more likely to be treated by an out-of-network provider (40 versus 20 percent) and were four times more likely to receive a surprise outpatient out-of-network bill (16 versus 4 percent) due to not initially knowing that a provider was out of network.
“A federal standard for directory accuracy, stronger enforcement of existing laws with insurers liable for directory errors, and additional monitoring by regulators may be needed,” the authors write.
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