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Showing 1-20 of 2,030 results for "out-of-network"

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A photo of a mother holding her infant son while looking at medical bills.

A Mom’s $97,000 Question: How Was Her Baby’s Air-Ambulance Ride Not Medically Necessary?

By Molly Castle Work March 25, 2024 KFF Health News Original

There are legal safeguards to protect patients from big bills like out-of-network air-ambulance rides. But insurers may not pay if they decide the ride wasn’t medically necessary.

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An Arm and a Leg: Meet the Middleman’s Middleman

By Dan Weissmann June 25, 2024 Podcast

Why are patients facing bigger bills than they expect for out-of-network care? In this episode of “An Arm and a Leg,” the show explains the hidden mechanics of MultiPlan, a data firm that helps health insurers set these rates and make bigger returns.

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A photo of a man standing outside for a portrait with dramatic lighting.

Sign Here? Financial Agreements May Leave Doctors in the Driver’s Seat

By Katheryn Houghton April 30, 2024 KFF Health News Original

Agreeing to an out-of-network doctor’s own financial policy — which generally protects their ability to get paid and may be littered with confusing insurance and legal jargon — can create a binding contract that leaves a patient owing.

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A photo shows a woman holding her infant child while facing a window.

Surprise-Billing Law Loophole: When ‘Out of Network’ Doesn’t Quite Mean Out of Network

By Harris Meyer February 28, 2023 KFF Health News Original

Billing experts and lawmakers are playing catch-up as providers find ways to get around new surprise-billing laws, leaving patients like Danielle Laskey of Washington state with big bills for emergency care.

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Three ambulances are lined up outside of an emergency room of a children's hospital in Orange, CA.

New California Law Offers Fresh Protection From Steep Ambulance Bills

By Bernard J. Wolfson November 7, 2023 KFF Health News Original

The law, which takes effect Jan. 1, prohibits out-of-network ground ambulance operators from billing patients more than they would pay for in-network rides. It also caps how much the uninsured must pay.

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A photo of a mother with her daughter outside. The young girl is holding a doll and looking at flowers with her mom.

An Insurer Agreed To Cover Her Surgery. A Politician’s Nudge Got the Bills Paid.

By Cara Anthony August 26, 2025 KFF Health News Original

A kindergartner in Missouri needed eye surgery. Her insurer granted approval for her to see a specialist nearby, yet her parents were confused when they still owed more than $13,000. Then her uncle, a former state senator, reached out to a colleague who contacted the hospital and the insurer.

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When Hospitals and Insurers Fight, Patients Get Caught in the Middle

By Bram Sable-Smith September 2, 2025 KFF Health News Original

About 90,000 people spent months in limbo as central Missouri’s major, and often only, provider fought over insurance contracts. Patients getting caught in the crossfire of disputes has become a familiar complication, as about 8% of hospitals have left an insurer network since 2021. Trump administration policies could accelerate the trend.

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An Arm and a Leg: How a Surprise Bill Can Hitch a Ride to the Hospital

By Dan Weissmann August 16, 2023 Podcast

The No Surprises Act has helped rein in out-of-network medical bills, but ground ambulances are a costly exception. Hear why this service can still hit patients with big bills and what to do if you get one.

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A photo of a young man posing for a portrait outside. A white car drives up the street behind him.

A Runner Was Hit by a Car, Then by a Surprise Ambulance Bill

By Sandy West February 28, 2025 KFF Health News Original

A San Francisco man had friends drive him to the hospital after he was hit by a car. Doctors checked him out, then sent him by ambulance to a trauma center — which released him with no further treatment. The ambulance bill? Almost $13,000.

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A closely cropped photo of a senior woman holding a paper letter. She presses her hand to her lips as she makes a stressed expression.

Surprise Medical Bills Were Supposed To Be a Thing of the Past. Surprise — They’re Not.

By Elisabeth Rosenthal July 18, 2025 KFF Health News Original

The No Surprises Act, which was signed in 2020 and took effect in 2022, was heralded as a landmark piece of legislation that would protect people who had health insurance from receiving surprise medical bills. And yet bills that take patients by surprise keep coming.

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A photo illustration of a person's head with their brain drawn as tangled threads. Three hands work to unknot the threads.

Trump Team Faces Key Legal Decision That Could Put Mental Health Parity in Peril

By Aneri Pattani Updated May 13, 2025 Originally Published May 9, 2025 KFF Health News Original

The administration is facing a May 12 deadline to declare if it will defend Biden-era regulations that aim to enforce laws requiring parity in insurance coverage of mental and physical health care.

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A photo of President Trump at the White House speaking into a microphone, pointing with his hand.

Trump Vowed To End Surprise Medical Bills. The Office Working on That Just Got Slashed.

By Noam N. Levey Updated March 5, 2025 Originally Published March 4, 2025 KFF Health News Original

The Trump administration’s first round of sweeping staff cuts to federal agencies eliminated dozens of positions at the Center for Consumer Information and Insurance Oversight, which is tasked with implementing the No Surprises Act.

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A photo shows Brenna Kearney sitting at home as her daughter, Joey, plays.

A Baby Spent 36 Days in an In-Network NICU. Why Did the Hospital Next Door Send a Bill?

By Harris Meyer January 30, 2023 KFF Health News Original

A baby spent more than a month in a Chicago NICU. A big bill revealed she was treated by out-of-network doctors from the children’s hospital next door. Her parents were charged despite a state law protecting patients from such out-of-network billing — and sent to collections when they didn’t pay up.

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A photo of an ambulance. Paramedics load a patient on a gurney into the ambulance.

Insurers Fight State Laws Restricting Surprise Ambulance Bills

By Rae Ellen Bichell and Katheryn Houghton July 9, 2025 KFF Health News Original

A Colorado bill banning surprise billing for ambulance rides passed unanimously in both legislative chambers, only to be met with a veto from the governor. As more states pass such legislation, some are hitting the same snag — concerns about raising premiums.

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The No Surprises Act Comes With Some Surprises

By Elisabeth Rosenthal February 14, 2024 KFF Health News Original

The No Surprises Act, the landmark law intended to protect patients from surprise out-of-network medical bills, has come with, well, some surprises. A little more than two years after it took effect, there’s good and bad news about how it’s working. First, it’s important to note that the law has successfully protected millions of patients […]

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KFF Health News' 'What the Health?': Democrats Make This Shutdown About the ACA

October 2, 2025 Podcast

The foreshadowed federal shutdown came after Congress failed to pass required spending bills, with Democrats demanding Republicans renew the expiring Affordable Care Act subsidies in exchange for their votes. While a shutdown does not affect Medicare and Medicaid, it could eventually hinder activities from every corner of the Department of Health and Human Services. Meanwhile, as Democrats and Republicans point fingers, HHS Secretary Robert F. Kennedy Jr. pursues policies and personnel that would undermine vaccines. Lauren Weber of The Washington Post, Shefali Luthra of The 19th, and Rachel Cohrs Zhang of Bloomberg News join KFF Health News’ Julie Rovner to discuss the news. Also this week, Rovner interviews KFF Health News’ Cara Anthony, who wrote a recent “Bill of the Month” feature about an out-of-network eye surgery that left one kindergartner’s family with a big bill.

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A glitchy photo illustration of a laptop opened with the healthcare.gov website opened.

A Guide To Finding Insurance at 26‌

By Elisabeth Rosenthal August 11, 2025 KFF Health News Original

It’s a difficult rite of passage for young adults without job-based insurance. Here are some tips for getting started.

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A portrait of a woman outside her apartment.

When a Quick Telehealth Visit Yields Multiple Surprises Beyond a Big Bill

By Darius Tahir December 19, 2023 KFF Health News Original

For the patient, it was a quick and inexpensive virtual appointment. Why it cost 10 times what she expected became a mystery.

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A collage of eight photographs from Bill of the Month articles.

‘Bill of the Month’: The Series That Dissects and Slashes Medical Bills

By Elisabeth Rosenthal December 20, 2024 KFF Health News Original

Since 2018, readers and listeners sent KFF Health News-NPR’s “Bill of the Month” thousands of questionable bills. Our crowdsourced investigation paved the way for landmark legislation and highlighted cost-saving strategies for all patients.

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Emergency Physicians Decry Surprise Air-Ambulance Bills

By Molly Castle Work March 27, 2024 KFF Health News Original

Emergency room doctors say insurers are increasingly declining to cover costly air-ambulance rides for critically ill patients, claiming they aren’t medically necessary. And the National Association of EMS Physicians says the No Surprises Act, enacted in 2022, is partly to blame. The law protects patients from many out-of-network medical bills by requiring insurers and providers […]

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