The No Surprises Act Gives Patients More Rights, But Medical Billing Hassles Remain

The No Surprises Act, which went into effect at the beginning of 2022, has offered consumers legal protections against unfairly high medical bills by closing several loopholes in the law.  Before this year, patients could face bills for hundreds or thousands of dollars from out-of-network providers who treated them on an emergency basis.  This was because, even if the patients had health insurance that covered emergency room visits, the ER physicians, radiologists, and anesthesiologists who treated the patient during the visit could still bill patients at out-of-network rates if those doctors did not have an in-network relationship with the patients’ insurers.  Now the No Surprises Act requires all providers who treat patients on an emergency basis to bill patients for those emergency services at the same rate as in-network providers, regardless of whether the patients are insured through employer-provided plans, a health insurance marketplace, or federal programs such as Medicare or Medicaid.  It also reduces the amount that doctors can bill uninsured patients for emergency services.  While this is certainly an improvement over the previous situation, unfairly expensive medical bills can still sometimes take customers by surprise.  If you are struggling with medical debt, contact a Philadelphia debt collection abuse lawyer.

Loopholes in the No Surprises Act

The No Surprises Act only covers emergency services rendered on or after January 1, 2022.  This means that, if you went to the emergency room in December 2021, you cannot invoke the No Surprises Act to make the bills from ER physicians and in-hospital radiologists shrink to a fraction of their original size.  Another loophole is that the definition of “emergency services” is narrower than most patients would expect.  Not all urgent care clinic visits count as emergency services.  Even though it isn’t so easy to make out-of-network bills from previous years disappear, you can still settle the bills and set up payment plans on a bill-by-bill basis.

What to Do If You Get an Unpleasant Surprise

The new law puts much more responsibility on doctors and insurance companies to work out the details of payment and write-offs without unloading the financial burden onto patients and then selling the debt to collection agencies when the patients can’t pay.  Doctors’ offices and insurance companies make mistakes, though.  If a bill seems unfair, it probably is.  It takes some work, but you can get the doctor’s office to correct the amount.  You can do this by looking up the insurance billing codes from your explanation of benefits on Google and then calling the doctors’ office, insurance company, or both.  If your medical debt problems go beyond a single visit to the ER, you may need the help of a consumer law attorney.

Contact Louis S. Schwartz About Getting Free From Medical Debt

A Philadelphia consumer law attorney can help you settle or consolidate medical debts from the era before the No Surprises Act.  Contact Louis S. Schwartz at CONSUMERLAWPA.com to set up a free, confidential consultation.

Source:

nytimes.com/2022/06/30/well/live/surprise-medical-bills.html