Supported by:
American Academy of Orthopaedic Surgeons
American Association of Neurological Surgeons
American College of Emergency Physicians
American College of Radiology
American Society of Anesthesiologists
American Society of Plastic Surgeons
College of American Pathologists
Congress of Neurological Surgeons
When insured patients are treated in the hospital, they should be confident in the knowledge that their health insurance will cover them. Unfortunately, a growing number of these patients are finding out too late that their coverage is far less comprehensive than they thought. Increasingly, insurers are making unsuspecting patients responsible for additional payments of covered services provided by hospital-based physicians who are not in their insurer’s network. Insurers have been further worsening this problem by enticing consumers to enroll in plans with ever-growing deductibles and ever-narrowing networks of providers. These are intentional business decisions by the insurers that allow them to reduce costs by shifting significantly more of the cost-sharing burden onto patients and by limiting the pool of physicians in their networks to those who agree to contract at greatly reduced rates that may be well below market value. Since the insurance industry is intensifying its efforts to narrow networks further and force more physicians out of network, we believe a fair and equitable solution to the out-ofnetwork balance billing issue should be developed that protects unsuspecting patients from facing significant financial hardships simply because the hospital services they needed at that moment were provided by an out-ofnetwork physician. The following shared principles of consensus are agreed to and will be supported by hospital based physician specialties:
Click here to view the full AANS/CNS Consensus Principles on Insurance Coverage for Out-Of-Network Care Provided By Hospital-Based Physicians.
