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Radiologists ‘especially successful’ in surprise-billing disputes, notching payments 500% above QPA
Radiology Business August 26, 2024
Radiologists have been “especially successful” in surprise-billing disputes, notching a median prevailing offer about 500% higher than the qualifying payment amount, according to new research published in Health Affairs [1].
Surgeons and neurologists fared even better in contested cases logged over the last two quarters of 2023, scoring prevailing offers at 800% or more of the QPA. In contrast, hospitals prevailed less frequently than physicians, with their winning offers at a lower level (no higher than 250% of QPA in 2023).
“The evidence to date suggests that strategies of using [independent dispute resolution] are not uniform across the provider community,” lead author Jack Hoadley, PhD, a health policy expert at Georgetown University, and colleagues wrote Aug. 19. “System use is...
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