As we continue our national discussion of how to address surprise billing, one idea that keeps coming up – and needs to stop – is arbitration.
To back up – surprise bills occur when a patient is treated by an out-of-network provider – usually without their knowledge. This means there is no negotiated rate with the patient’s insurer and the provider can charge whatever they want.
There are several solutions that have been proposed to solve this problem, but if you are worried about rising healthcare costs, “arbitration” is probably the worst one.
The idea behind arbitration is that when a patient receives care from an out-of-network provider, the patient’s insurer and the provider are forced into arbitration. Here’s how one advocate for arbitration puts it:
"To ensure these disputes are addressed in a fair and equitable manner, Congress should establish an independent resolution process that allows healthcare experts to solve billing disputes between doctors and insurance companies — this would create a level playing field where doctors receive fair reimbursement rates."
This group’s vision is that at least three people – representatives from the insurer and the provider as well as a “non-conflicted third party” - sit down for however long they need to hash out a bill on a “case-by-case basis.” Imagine the cost of doing this for every hospital visit in North Carolina on a “case-by-case” basis.
It sounds less like a healthcare solution and more like an employment program for lawyers.
Arbitration is expensive. According to Progress Health “Experts point to potential costs including: $1,900 filing fee per case, $750 case management fee, and arbiter fees of $1,000 per hour. In many cases, these costs, coupled with additional legal fees, could quickly exceed the original bill.”
And who will pay for this? Ultimately, we all will in the form of higher premiums and higher healthcare costs.
We need to solve surprise billing, but not by adding more costly lawyers to the system.