A recent analysis of Health Care Cost Institute’s (HCCI) vast commercial claims database sought to explore the prevalence of these surprise bills associated with in-network hospital admissions across states and medical specialties. An examination of nearly 620,000 in-network inpatient admissions and all associated professional claims (both in- and out-of-network claims filed by the physician or other health care professional who rendered the service) across 37 states and the District of Columbia in 2016, found:
- The share of in-network hospital admissions with at least one associated out-of-network professional claim ranged from 1.7% in Minnesota to 26.3% in Florida;
- Anesthesiology accounted for the largest share (16.5%) of out-of-network professional claims associated with an in-network admission;
- Among the specialty categories studied, independent labs most often billed out-of-network as part of an in-network hospital admission (22.1% of the time).