How to Avoid Surprise Bills -- And the Pitfalls in the New Law

6 months ago 30
By Dan Weissmann

Wednesday, March 16, 2022 (Kaiser News) -- Patients are nary longer required to wage for out-of-network attraction fixed without their consent erstwhile they person attraction astatine hospitals covered by their health insurance since a national instrumentality took effect astatine the commencement of this year.

But the law’s protections against the infuriating, costly scourge of astonishment aesculapian bills whitethorn beryllium lone arsenic bully arsenic a patient’s cognition — and quality to marque definite those protections are enforced.

Here’s what you request to know.

Meet the No Surprises Act.

Studies person shown that astir 1 successful 5 exigency country visits effect successful a astonishment bill.

Surprise bills often travel from exigency country doctors and anesthesiologists, among others — specialists who are often extracurricular a patient’s security web and not chosen by the patient.

Before the instrumentality took effect, the occupation went thing similar this: Say you needed surgery. You picked an in-network infirmary — that is, 1 that accepts your health plan and has negotiated prices with your insurer.

But 1 of the doctors who treated you didn’t instrumentality your insurance. SURPRISE! You got a large bill, abstracted from the bills from the infirmary and different doctors. Your insurer didn’t screen overmuch of it, if it didn’t contradict the assertion outright. You were expected to wage the balance.

The caller law, known arsenic the No Surprises Act, stipulates, successful wide terms, that patients who question attraction from an in-network infirmary cannot beryllium billed much than the negotiated, in-network complaint for immoderate out-of-network services they person there.

Instead of leaving the diligent with an ...

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