Help Consumer Reports fight surprise medical bills

Elisabeth Rosenthal's New York Times article about outrageous surprise medical bills was the most e-mailed article on the site yesterday. And no wonder: Who wouldn't be outraged by five- or even six-figure bills from out-of-network doctors whom you never hired, or perhaps never even saw because they took care of you while you were out cold during surgery?

Here at Consumer Reports, we've been writing (and getting upset) about this problem for several years. We've collected hundreds of stories from consumers who were blindsided by unexpected bills, even though they did their best to follow their health plan's rules and be treated by doctors and hospitals who take part in their health plan's network. And when they tried to get help, doctors, hospitals, and insurance companies all gave them the same answer: "Not our problem. Pay up or else."

"They would call the doctor, call the insurance company, stay on hold forever only to find out there was no recourse," said Blake Hutson, an organizer for Consumer Reports' health advocacy campaigns.

Now we have moved on to work for a solution. We're inviting you to be a part of this effort.

We already have one big consumer victory to report. This year, New York State passed a law that puts responsibility for taking care of stealth bills where it belongs: on the insurance company and providers. Starting next year, New Yorkers surprised by out-of-network medical bills won't have to pay more than the usual co-pay for in-network care and will no longer face harassment from bill collectors. It will be up to the insurance company and provider to figure out how much money the the provider will ultimately collect.

We are working with advocates, legislators, regulators, and consumer groups across the country to get similar legislation passed in other states. If you're interested in joining the cause, or just want to learn about it, here's more information.

Find out how to select a health insurance plan and get our rankings of health plans nationwide.  

What to do if you get a surprise out-of-network bill

There's no guarantee that any of these steps will work, but you won't know unless you try. In order, you should:

1. Call the out-of-network doctor and ask for the bill to be lowered.
2. Contact your insurance company, tell it about the problem, and ask if it will use its influence with the doctor.
3. Contact your state insurance department and tell it your problem. Some states have consumer ombudsmen specifically assigned to help. "Even if they can't provide an immediate solution, every insurance department needs to be aware consumers are facing this issue," Hutson said.
4. Share your story with us. It may help to vent, and we use these stories to demonstrate to lawmakers and regulators how the problem is affecting real people.

—Nancy Metcalf

Got a question for our health insurance expert? Ask it here; be sure to include the state you live in. And if you can't get enough health insurance news here, follow me on Twitter @NancyMetcalf.