Surprise Billing in Surgical Care Episodes – Overview, Ethical Concerns, and Policy Solutions in Light of COVID-19

Although used interchangeably, balance billing and surprise billing represent distinct scenarios. Balance billing implies that a patient is billed directly by a provider for the difference between what the provider billed and what the insurer reimbursed. These circumstances often occur in emergencies and involve out-of-network (OON) providers because in-network providers are contractually prohibited from sending enrollees a balance bill....