Miscellaneous 

Is there a law against surprise medical bills?

Leia Doyle

Is there a law against surprise medical bills?

“Today’s Interim Final Rule is a major step in implementing the bipartisan No Surprises Act that will protect Americans from exorbitant health costs for unknowingly receiving care from out-of-network providers.” The regulations issued today will take effect for health care providers and facilities January 1, 2022.

What can I do about a surprise medical bill?

Negotiate the bill. There are a few ways to do this if you’re stuck with an unexpected out-of-network bill. First, call the insurer and ask whether it will consider a one-time exception and agree to cover the bill at the in-network rate. If that doesn’t work, you can file an appeal.

How common are surprise medical bills?

Surprise billing had been widely seen, by academics and legislators, as one of the most exasperating common practices in medicine. Millions of Americans receive these type of bills each year, with as many as one in five emergency room visits resulting in such a charge.

How does surprise billing work?

Surprise billing is sometimes called surprise balance billing, or simply balance billing because the out-of-network provider essentially bills the patient directly for the difference, or balance, after the insurer has paid their part. Even under these laws, a patient still may not be covered in every situation.

Why do surprise medical bills happen?

Surprise medical billing occurs when a patient receives a larger-than-expected medical bill due to their care provider being out-of-network. Emergency care situations and nonsurgical hospital stays, when patients may not be able to choose health care providers covered by their insurance.

How do you deal with balance billing?

Steps to Fight Against Balance Billing

  1. Review the Bill. Billing departments in hospitals and doctor offices handle countless insurance claims on a daily basis.
  2. Ask for an Itemized Billing Statement.
  3. Document Everything.
  4. Communicate with Care Providers.
  5. File an Appeal with Insurance Company.