Emergency docs, insurer dispute could lead to surprise patient bills

A contract standoff between emergency physicians and Independence Blue Cross (IBC) could force thousands of patients to foot unexpected medical bills, phillyBurbs.com reported.

Abington (Pa.) Emergency Physicians Associates, which staffed Abington Memorial Hospital and Lansdale Hospital, was unable to reach a reimbursement agreement with the Philadelphia-based insurer and, therefore, let its contract expire June 30.

Because emergency physician care is now out-of-network, IBC patients may get billed for charges not paid by the insurer, according to Abington Health System President and CEO Laurence Merlis. "We regret this inconvenience and hope that this situation is resolved very quickly," Merlis said July 1 in a letter.

The reimbursement dispute will affect thousands of patients, as roughly 30 percent of Abington Memorial's 105,000 ED patients each year have IBC insurance.

Contract issues aside, sicker patients are visiting emergency departments more often, not to mention staying there longer, American Medical News reported.

While the volume of ED visits rose 15 percent to 123.8 million in 2008, the number of high-acuity patients jumped by 23 percent. Those sicker patients spent 41 percent more time in the ED than those with low-acuity medical conditions, according to a June Annals of Emergency Medicine study, the article noted.

For more:
- read the phillyBurbs.com blog post
- here's Abington Health's letter to IBC patients (.pdf)
- read the amednews article
- check out the ED study (.pdf)

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