Post by Drifter on Jan 3, 2022 0:09:00 GMT -5
Surprise Medical Bill Ban Now in Effect: What to Do If You Get One
On Jan. 1, 2022, Americans will be protected from receiving surprise medical bills under the No Surprises Act.
Surprise medical bills occur when a patient sees an out-of-network provider through no fault of their own.
Insurers and providers will negotiate balance bills, effectively leaving patients out of the middle.
Beginning Jan. 1, 2022, a new law will take effect that ends surprise medical bills for insured people receiving emergency medical care and other health services in the United States.
Congress passed the No Surprises Act last December with bipartisan support, establishing new federal protections against surprise medical bills.
But what types of medical bills are covered under the law, how does it protect consumers, and will it affect overall healthcare costs and premiums?
Healthline spoke with two healthcare policy experts to shed some light on these questions.
What are surprise medical bills?
The No Surprises Act defines surprise medical in a specific context.
“This is important because there are numerous situations that can be surprising but don’t fall into this official bucket of surprise medical bills,” said Jack Hoadley, PhD, research professor emeritus in the Health Policy Institute of Georgetown University’s McCourt School of Public Policy.
These situations may include not being aware that your health insurance plan has a high deductible or that a certain procedure costs so much.
While such bills can certainly be surprising, they are not covered under the No Surprises Act.
“When we talk about surprise medical bills for the purposes of the No Surprises Act, it means situations where you end up using an out-of-network healthcare facility or healthcare provider, generally, through no fault of your own,” Hoadley explained.
This most commonly occurs in emergency situations.
If an ambulance brings you to a hospital that is out of network, for example, you may receive a costly surprise medical bill for the services performed.
“That’s not something you chose,” Hoadley said. “You got to whatever hospital you were taken to.”
Even in hospitals that are in your insurance plan’s network, there are situations in which a doctor who sees you is out of network. This can happen during an urgent or elective procedure.
“So even if you’ve done your due diligence and pick an in-network facility and picked an in-network surgeon to do your procedure or an in-network obstetrician to deliver your baby, while you’re there, you can also be treated by an out-of-network anesthesiologist, or radiologist, or a cardiologist,” Hoadley said. “And again, it’s not something you were told about or could control.”
The result of these scenarios is often a surprise bill asking people to pay the “balance bill,” or the difference between what the insurance company paid and the total charged.
Research has found 1 in 5 inpatient emergency department cases may lead to surprise medical bills.
Studies show surprise medical bills average more than $1,200 for anesthesia, $2,600 for surgical assistants, and $750 for childbirth.
Read more HERE
On Jan. 1, 2022, Americans will be protected from receiving surprise medical bills under the No Surprises Act.
Surprise medical bills occur when a patient sees an out-of-network provider through no fault of their own.
Insurers and providers will negotiate balance bills, effectively leaving patients out of the middle.
Beginning Jan. 1, 2022, a new law will take effect that ends surprise medical bills for insured people receiving emergency medical care and other health services in the United States.
Congress passed the No Surprises Act last December with bipartisan support, establishing new federal protections against surprise medical bills.
But what types of medical bills are covered under the law, how does it protect consumers, and will it affect overall healthcare costs and premiums?
Healthline spoke with two healthcare policy experts to shed some light on these questions.
What are surprise medical bills?
The No Surprises Act defines surprise medical in a specific context.
“This is important because there are numerous situations that can be surprising but don’t fall into this official bucket of surprise medical bills,” said Jack Hoadley, PhD, research professor emeritus in the Health Policy Institute of Georgetown University’s McCourt School of Public Policy.
These situations may include not being aware that your health insurance plan has a high deductible or that a certain procedure costs so much.
While such bills can certainly be surprising, they are not covered under the No Surprises Act.
“When we talk about surprise medical bills for the purposes of the No Surprises Act, it means situations where you end up using an out-of-network healthcare facility or healthcare provider, generally, through no fault of your own,” Hoadley explained.
This most commonly occurs in emergency situations.
If an ambulance brings you to a hospital that is out of network, for example, you may receive a costly surprise medical bill for the services performed.
“That’s not something you chose,” Hoadley said. “You got to whatever hospital you were taken to.”
Even in hospitals that are in your insurance plan’s network, there are situations in which a doctor who sees you is out of network. This can happen during an urgent or elective procedure.
“So even if you’ve done your due diligence and pick an in-network facility and picked an in-network surgeon to do your procedure or an in-network obstetrician to deliver your baby, while you’re there, you can also be treated by an out-of-network anesthesiologist, or radiologist, or a cardiologist,” Hoadley said. “And again, it’s not something you were told about or could control.”
The result of these scenarios is often a surprise bill asking people to pay the “balance bill,” or the difference between what the insurance company paid and the total charged.
Research has found 1 in 5 inpatient emergency department cases may lead to surprise medical bills.
Studies show surprise medical bills average more than $1,200 for anesthesia, $2,600 for surgical assistants, and $750 for childbirth.
Read more HERE
