Nearly half of insured Americans have faced surprise medical bills in the past year, but a majority do not dispute billing errors or coverage denials, a new Commonwealth Fund survey finds.
That inaction — which stems largely from an ignorance that such bills and denials can be challenged — can be costly, because such efforts often work, according to the study released Thursday by the private nonprofit foundation.
According to the Commonwealth Fund, 45% of 7,873 insured adults surveyed nationwide said they had been billed for a service they believed should have been covered. Nearly one in five, or 17%, said they had been denied coverage for a service recommended by a doctor.
Yet less than half of people who reported billing errors or coverage denials disputed them, mostly because they didn’t know they had the right to do so, according to the survey conducted last year.
The consequences of coverage denials were also illustrated in the study, with nearly 60% of respondents reporting delays in care and nearly half (47%) reporting worsening of their health as a result.
“This highlights a troubling reality: Many people with insurance are facing unexpected bills and being denied care recommended by their doctors,” Sara Collins, Commonwealth Fund senior fellow and vice president for health care coverage and access, told CBS MoneyWatch. “And many don’t know what to do about it: People are confused about the health care process itself, both in terms of how things are billed and who is responsible,” Collins said.
The results of this study also contain positive information, the researcher noted.
“What’s encouraging, and what people should know,” is that more than a third of those who disputed medical bills had their balances reduced or eliminated, and half of those who disputed coverage denials were able to get some or all of the denied services approved, said Collins, a co-author of the report.
