Remember that time you received an unexpected medical bill in the mail? You had surgery, or maybe you had gone to the emergency room weeks before and thought your insurance would cover your bill. But, it turned out they didn’t cover it, and you’re left with an outrageous balance.
Well, there’s a new legislative bill in effect: the No Surprises Act! Continue reading to learn more about the No Surprises Act and what it means for your medical bill balances.
What is the No Surprises Act?
The No Surprises Act, which was signed in 2020 and has taken effect on January 1, 2022, prevents some healthcare providers from sending you unexpected medical bills. This may be the entire bill due to claim denial or the balance bill after insurance payment.
The No Surprises Act protects you from surprise bills when you receive emergency services from out-of-network facilities, non-emergency services from out-of-network providers practicing in in-network facilities, and air ambulance services.
How the No Surprises Act Affects Unexpected Medical Billings
So, what should you expect with the implementation of the No Surprises Act? Outlined below is what the No Surprises Act means for your medical bills.
Providers Must Give You an Estimate
Out- of-network providers are mandated to give you an estimate of your treatment before providing service. Hence, there would be no surprise when you get an unexpected bill. The estimate must also be made available at least 72 hours before the service is provided. This gives you time to compare prices with other providers before deciding to accept care. And the bill.
Providers Must Get Consent from You
Providers must get written consent from you to waive your No Surprise protection. That is, you must agree to receive balance billing or the entire bill when out-of-network. However, there are some scenarios they cannot ask you to give consent such as in an emergency.
Providers Can Decline You Their Services
Although the No Surprises Act protects you from unexpected medical bills, providers retain the right to decline their services to you. Say you refuse to sign a consent form waiving your No Surprises protection; the provider can decide not to provide their services to you.
You May Still Get a Surprise Bill
Yes, we said with the No Surprises Bill Act, unexpected bills would be a thing of the past. But the thing is, you may still get a surprise bill in the mail. This is because all of the scenarios the law covers are complex with mandates at the federal, state, and insurance plan levels. So, be cautious when signing papers to avoid accidentally signing away your No Surprises protection. If you get an unexpected bill that you think should have been covered by the No Surprises Act, you can dispute the bill. But, getting a resolution can be difficult and takes time.
MBCR understands the challenges in receiving a medical bill and successfully resolving a health insurance claim issue. Learn more at www.medicalbillandclaimresolution.com.