Out-of-network ER doctor bill — am I protected?
Yes — the No Surprises Act bans balance billing for emergency services and out-of-network providers at in-network facilities.
Since January 1, 2022, the federal No Surprises Act protects patients from balance billing in three scenarios: emergency services from out-of-network providers, post-stabilization care, and out-of-network providers at in-network facilities (anesthesiology, radiology, pathology, ER doctors). You pay only IN-NETWORK cost-sharing.
Steps
- Contact the provider's billing office and explicitly cite the No Surprises Act protection
- Call your insurer to confirm in-network cost-sharing was applied
- If still billed for the balance, file a complaint with the No Surprises Help Desk at 1-800-985-3059
- Also file with your state insurance department
Frequently asked questions
Out-of-network ER doctor bill — am I protected?
Since January 1, 2022, the federal No Surprises Act protects patients from balance billing in three scenarios: emergency services from out-of-network providers, post-stabilization care, and out-of-network providers at in-network facilities (anesthesiology, radiology, pathology, ER doctors). You pay only IN-NETWORK cost-sharing.
What are the steps?
1. Contact the provider's billing office and explicitly cite the No Surprises Act protection; 2. Call your insurer to confirm in-network cost-sharing was applied; 3. If still billed for the balance, file a complaint with the No Surprises Help Desk at 1-800-985-3059; 4. Also file with your state insurance department
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