NEW Surprise Billing Notice:
Read below and click on the link provided for more information:
Effective January 1, 2022, the No Surprises Act, which Congress passed as part of the Consolidated Appropriations Act of 2021, is designed to protect patients from surprise bills for emergency services at out-of-network facilities or for out-of-network providers at in-network facilities, holding them liable only for in-network cost-sharing amounts. The No Surprises Act also enables uninsured patients to receive a good faith estimate of the cost of care.
Billing Disclosures – Your Rights and Protections Against Surprise Medical Bills
When you get emergency care or get treated by an out-of-network provider at an in-network hospital or ambulatory surgical center, you are protected from surprise billing or balance billing.
What is “balance billing” (sometimes called “surprise billing”)?
When you see a doctor or other healthcare provider, you may owe certain out-of-pocket costs, such as a copayment, coinsurance, and/or a deductible. You may have other costs or have to pay the entire bill if you see a provider or visit a healthcare facility that isn’t in your health plan’s network.
“Out-of-network” describes providers and facilities that haven’t signed a contract with your health plan. Out-of-network providers may be permitted to bill you for the difference between what your plan agreed to pay and the full amount charged for a service. This is called “balance billing.” This amount is likely more than in-network costs for the same service and might not count toward your annual out-of-pocket limit.
“Surprise billing” is an unexpected balance bill. This can happen when you can’t control who is involved in your care — like when you have an emergency or when you schedule a visit at an in-network facility but are unexpectedly treated by an out-of-network provider.
Frequently Asked Questions
What is the No Surprises Act?
The No Surprises Act, effective January 1, 2022 as part of the Consolidated Appropriations Act of 2021, protects patients from surprise bills for emergency services at out-of-network facilities, or from out-of-network providers at in-network facilities — holding patients liable only for in-network cost-sharing amounts. It also allows uninsured patients to receive a good faith estimate of care costs.
Am I protected from balance billing when I get emergency care?
Yes. When you receive emergency care, or are treated by an out-of-network provider at an in-network hospital or ambulatory surgical center, you’re protected from surprise billing or balance billing.
What is “balance billing” (also called “surprise billing”)?
Balance billing is when an out-of-network provider or facility bills you for the difference between what your health plan agreed to pay and the full charge for a service. This amount is typically higher than in-network costs and may not count toward your annual out-of-pocket limit. Surprise billing refers to an unexpected balance bill — for example, when you’re treated by an out-of-network provider during an emergency or at an in-network facility without being able to choose who treats you.
