This is called balance billing. Medicare and Medicaid programs have had similar rules in place for many years. They will walk you through the appropriate dispute process. The Consolidated Appropriations Act of contains requirements to protect people with private insurance from surprise medical bills. These rules were collectively known as the No Surprises Act.
Patients covered by the No Surprises Act NSA have a right to access emergency care from out-of-network providers without being charged extra. Nor should you get a surprise bill for non-emergency care if you go to a facility covered by your insurance. Sometimes what seems like a surprise bill has more to do with the structure of your health plan than the bill itself. For example, you may have a high-deductible plan but not realize how much of the deductible you still have to pay.
Review your explanation of benefits to better understand what your insurance covers after you receive care. Then compare that to your bill.
In the case of a planned surgery, for example, a good faith estimate would include:. The NSA says uninsured and self-pay patients those who pay out of their own pocket should get a good faith estimate if they want one. Disputes must be filed with days of the bill date. If you received a surprise bill or have questions about the No Surprises Act, you can contact our office.
If you still have questions, or you have a dispute that could not be resolved by speaking to us, you can contact the No Surprises Help Desk for free at If you receive a surprise bill, please contact us as soon as possible.
