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States and Congress are working to address the “surprise billing” that can hit consumers after a hospital stay or other care in which they learn that they owe thousands of dollars for services they thought were covered by insurance. The legislation is popular among consumers but could create significant potential liabilities for hospitals and health systems. Reducing the risk of those penalties and other consequences will require the risk manager to work with multiple departments within the organization to prevent surprise bills from going out to patients.
Financial Disclosure: Author Greg Freeman, Editor Jill Drachenberg, Editor Jonathan Springston, Editorial Group Manager Leslie Coplin, Accreditations Manager Amy Johnson, MSN, RN, CPN, and Nurse Planner Maureen Archambault report no consultant, stockholder, speaker’s bureau, research, or other financial relationships with companies having ties to this field of study. Consulting Editor Arnold Mackles, MD, MBA, LHRM, discloses that he is an author and advisory board member for The Sullivan Group and that he is owner, stockholder, presenter, author, and consultant for Innovative Healthcare Compliance Group.